Thus, our modification considerably shortened the time taken for creating the maze in comparison to the Cox's maze procedure and was effective in restoring normal sinus rhythm in 80% of the patients.

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Hospital, Sion, Bombay, India Summary: A rare case of isolated pulmonary valve endocarditis associated with a double-chambered right ventricle in a nonaddict, was diagnosed on two-dimensional echocardiography and cardiac catheterization and angiography. The patient was successfully operated and the above findings confirmed on the operation table.Key words: double-chambered right ventricle, isolated pulmonic valve endocarditis A 12-year-old boy presented to us with history of high grade fever and easy fatiguability of 15 days duration. There was no history of narcotic habits or intravenous injections given prior to the onset of these symptoms. There was no other positive history. On general examination the patient was toxic with evidence of severe congestive cardiac failure. Cardiovascular examination revealed findings of severe pulmonic stenosis with mild pulmonary regurgitation. Electrocardiogram showed sinus rhythm, right axis deviation, and right ventricular hypertrophy with strain. Chest roentgenogram showed minimal cardiomegaly with oligemic lung fields. The main pulmonary artery was not dilated. Laboratory examination showed anemia and leukocytosis with raised erythrocyte sedimentation rate. Repeated blood cultures were negative. Mmode echocardiogram revealed normal mitral, tricuspid, and aortic valves. Pulmonic valve showed thick multilayered dense echoes with systolic flutter. Twodimensional echocardiogram in parastemal short-axis view showed a dense globular mass on the posterior pulmonic leaflet which moved into the main pulmonary artery during systole and right ventricular outflow tract during diastole suggestive of flail pulmonary valve (Figs. I and 2). The right ventricle was concentrically thickened and a thick muscular band was seen in the right ventricular (RV) cavity. Cardiac catheterization showed RV pressures of 110/6 mmHg and systolic gradient of 90 mmHg across the RV body and RV outflow tract. Main pulmonary artery pressure was 20/12 mmHg. Right ventricular angiogram in frontal view showed a hypertrophied muscle band which divided the RV cavity in two, highly suggestive of doublechambered right ventricle (Fig. 3). There were no other associated defects. The patient was subsequently taken up for surgery after control of failure and treatment of infective endocarditis. On the operating table, the right ventricular cavity showed a thick hypertrophied muscle band dividing the right ventricular cavity into two chambers (proximal high and distal low pressure chambers) as seen on angiography. The posterior pulmonic valve was thickened, calcified, and was fenestrated in the center, suggesting healed infective endocarditis. AU other valves were normal. The muscle band was excised and pulmonic

A case of aortic origin of the right pulmonary artery with right ventricular endocardial fibroelastosis is reported. Its diagnostic features, surgical aspects, and postmortem findings are discussed. This is a rare combination. The relevant literature is reviewed.