The authors report the case of an acquired left ventricle--right atrial communication after closed chest trauma. This communication was associated with rupture of the aortic isthmus and complete atrioventricular block. The left-to-right shunt which was assumed for a long time to be a small, well-tolerated, ventricular septal defect, finally required surgical repair. The diagnosis was eventually made clear by Doppler color flow mapping which was of great value in orienting the surgical procedure.
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