This newborn girl was the 2620-g product of an uncomplicated twin gestation and was born at 38 weeks' gestation via spontaneous vaginal delivery. Her Apgar scores were 6 at age 1 minute and 7 at age 5 minutes. At birth, she was mildly cyanotic and tachypneic.
Results of physical examination revealed a harsh, grade 3/6 systolic ejection murmur with diastolic radiation over the right-lower sternal border. The lungs were clear to auscultation. The infant underwent intubation soon after birth because of increasing respiratory distress, underwent extubation at age 24 hours, and was weaned to room air at age 48 hours.
A frontal roentgenogram of the chest (Fig 1) and a computed tomogram of the chest with intravenous contrast enhancement (Fig 2) were obtained at age 1 day. Serial chest roentgenograms were obtained at ages 2, 3, and 6 days (Fig 3).
Denouement and Discussion
Absent Pulmonic Valve Presenting With Congenital