Congenital absence of the pulmonary valve associated with tricuspid atresia and intact ventricular septum.

visualized. The left circumflex coronary artery showed an area of 50 percent narrowing prior to its bifurcation into the obtuse marginal branch. In addition, there was a significant 70-80 percent stenosis at the origin of the obtuse marginal branch, with no distal circumflex coronary artery visualized. The right coronary artery was a large vessel and was totally occluded at the acute margin, with no distal vessel visualized. The left ventriculogram was still abnormal, showing an akinetic proximal inferior wall, but the apex and anterior wall appeared to contract normally. No further surgical therapy was recommended because the patient was asymptomatic. At the present time, three and one half years after myocardial infarction and dissection of the right coronary artery, the patient is without cardiac symptoms, and is employed full time as a maintenance worker in a county highway department.