HEART - Multiple congenital anomalies

This specimen comprises a heart opened anteriorly to display the chambers. Two significant abnormalities are present. Firstly, the right and left ventricular outflow tracts enter the same major vessel and secondly, there is a small ventricular septal defect. The VSD has arisen due to failure of the aortico-pulmonary septum to fully develop, resulting in the persistence of a connection between the two ventricles as well as the aorta and pulmonary trunk.
This baby was born at approximately 34 weeks gestation by an assisted breech delivery. Apgars were 3 at 1 minute and 6 at 5 minutes. Clinical examination at delivery showed an imperforate anus and talipes equinovarus. Duodenal atresia was also discovered on x-ray examination. Intermittent positive pressure ventilation was undertaken, however the neonate remained hypoxic, hypercapnoeic and acidotic and died some 12 hours after delivery.