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Figure 4 (a) Necropsy specimen from a 35-year-old man in group A (ventricular septal defect, VSD). There is aneurysmal dilation of the pulmonary trunk (PT). The patient died at home. The cause of death was not established. RV = right ventricle. (b) Necropsy specimen from a 27-year-old man in group A (VSD). Sudden death was due to rupture (arrow) of an aneurysmal PT.