 studi ventricular septal defect associ aortic insuffici clinic electrocardiograph radiograph hemodynam find 12 children combin ventricular septal defect aortic insuffici present left-to-right shunt determin small moder aortic insuffici document aortographi 11 patient clinic indic aortic insuffici manifest aortic diastol murmur appear averag ag 6 year 7 patient concomit widen puls pressur 4 progress left ventricular hypertrophi electrocardiograph progress cardiac hypertrophi aortic dilat x-rai examin 2 patient progress hemodynam disabl appear common childhood 