Study of Types and Complications of Ventricular Septal Defect in Our Institute
Keywords:
Venticular Septal Defect, Aortic Cusp Prolapse, Aortic Regurgitation, Severe Pulmonary Hypertension
Abstract
Objective: To determine the frequency of various types of ventricular septal defects (VSD) and associated complications in local paediatric population.Methods: A cross sectional descriptive study was conducted on children undergoing echocardiography in a single centre from May 2013 to January 2016 at CVTS Department Grant Medical College, Mumbai, Maharashtra. The data on all children below 15 years of age undergoing detailed transthoracic two-dimensional echo and doppler studies was reviewed. Cases with isolated ventricular septal defects were studied for age of presentation, gender, type, and associated complications.Results: A total of 70 patients with congenital heart diseases underwent echocardiography and surgical procedure during this period. A total of 15 patients had isolated VSD (21.4%). Mean age was 3.1 ± 3.64 years (range: 4 years to 15 years). Females were 5 (33.3%) and males were 10 (66.6%). Of 15 patients, 11 (73.3%) were Perimembranous type, 2 (13.3%) were muscular type, 1(6.66%) were doubly committed subarterial type and 1 (6.66%) inlet VSD. Small, moderate and large VSDs were 5(33.3%), 6(40 %) and 4(26.6 %) respectively. Severe pulmonary hypertension was noted in 5 (33.3%) cases. Aortic valve prolapse was present in 5 (33.3%) cases and varying degrees of aortic valve regurgitation was seen in 3 (20 %) patients. Right ventricular outflow tract obstruction was found in 1 (6.66%) case. No Echo evidence of infective endocarditis.Conclusion: Perimembranous ventricular septal defect was found to be the commonest type of ventricular septal defect. Large ventricular septal defects usually lead to severe pulmonary hypertension. Severe pulmonary hypertension was the commonest complication followed by Aortic Valve Prolapse and Aortic Regurgitation. Rest of the complications were rare.References
1.Praagh R, Geva T, Kreutzer J. Ventricular septal defects: how shall we describe, name and classify them? J Am Coll Cardiol 1989; 14: 1298-9.
2.Park MK. Pediatric cardiology for Practitioners. 5th ed. Philadelphia: Mosby Elsevier, 2008; pp 166-75.
3.Soto B, Becker AE, Moulaert AJ, Lie JT, Anderson RH. Classification of ventricular septal defects. Br Heart J 1980; 43: 332-43.
4.Wickramasinghe P, Lamabadusuriya SP, Narenthiran S. Prospective study of congenital heart disease in children. Ceylon Med J 2001; 46: 96-8.
5.Wu MH, Wu JM, Chang CI, et al. Implication of aneurysmal transformation in isolated perimembranous ventricular septal defect. Am J Cardiol 1993; 72: 596-601.
6.McDaniel NL, Gutgesell HP. Ventricular septal defect. In: Allen HD, Driscoll DJ, Sheddy RE, Feltes TF (edi). Moss and Adams'heart disease in infants, children and adolescent. 7th ed. Philadelphia: Lippincott Williams & Willkins, 2008; pp 667-82.
7.Lue HC, Sung TC, Hou SH, Wu MH, Cheng SJ, Chu SH, et al. Ventricular septal defect in Chinese with aortic valve prolapse and aortic regurgitation. Heart Vessels 1981; 2: 111-6.
8.Kobayashi J, Koike K, Senzaki H, Kobayashi T, Trunemoto M, Ishizawa A, et al. Correlation of anatomic and hemodynamic features wtih aortic valve leaflet deformity in doubly committed subarterial ventricular septal defect. Heart Vessels 1999; 14: 240-5.
9.Tomita H, Arakaki Y, Ono Y, Yamada O, Yagihara T, Echigo S. Imbalance of cusp width and aortic regurgitation associated with aortic cusp prolapse in ventricular septal defect. Jpn Circ J 2001; 65: 500-4.
10.Chiu SN, Wang JK, Lin MT, Wu ET, Lu FL, Chang CI, et al. Aortic valve prolapse associated with outlet-type ventricular septal defect. Ann Thorac Surg 2005; 79: 1366-71.
11.Pongiglione G, Freedom RM, Cook D, Rowe RD. Mechanism of acquired right ventricular outflow tract obstruction in patients with ventricular septal defect: an angiocardiographic study. Am J Cardiol 1982; 50: 776-80.
12.Zielinsky P, Rossi M, Haertel JC. Subaortic fibrous ridge and ventricular septal defect: role of septal malalignment. Circulation 1987; 75: 1124-9.
13.Corone P, Doyon F, Gaudeau S. Natural history of ventricular septal defect. A study involving 790 cases. Circulation 1977; 55: 908-15.
14.Perry GJ, Helmeke F, Nanda NC, Byard C, Soto B. Evaluation of aortic insufficiency by doppler color flow mapping. J Am Col Cardiol 1987; 9: 952-9.
15.Brauner R, Birk E, Blieden L, Sahar G, Vidne BA. Surgical management of ventricular septal defect with aortic valve prolapse: clinical considerations and results. Eur J Cardiothoracic Surg 1995; 9: 315-9.
16.Ando M, Takao A. Pathological anatomy of ventricular septal defect associated with aortic valve prolapse and regurgitation. Heart Vessels 1986; 2: 117-26.
17.Glen S, Burns J, Bloomfield P. Prevalence and development of additional cardiac abnormalities in 1448 patients with congenital ventricular septal defects. Heart 2004; 90: 1321-5.
2.Park MK. Pediatric cardiology for Practitioners. 5th ed. Philadelphia: Mosby Elsevier, 2008; pp 166-75.
3.Soto B, Becker AE, Moulaert AJ, Lie JT, Anderson RH. Classification of ventricular septal defects. Br Heart J 1980; 43: 332-43.
4.Wickramasinghe P, Lamabadusuriya SP, Narenthiran S. Prospective study of congenital heart disease in children. Ceylon Med J 2001; 46: 96-8.
5.Wu MH, Wu JM, Chang CI, et al. Implication of aneurysmal transformation in isolated perimembranous ventricular septal defect. Am J Cardiol 1993; 72: 596-601.
6.McDaniel NL, Gutgesell HP. Ventricular septal defect. In: Allen HD, Driscoll DJ, Sheddy RE, Feltes TF (edi). Moss and Adams'heart disease in infants, children and adolescent. 7th ed. Philadelphia: Lippincott Williams & Willkins, 2008; pp 667-82.
7.Lue HC, Sung TC, Hou SH, Wu MH, Cheng SJ, Chu SH, et al. Ventricular septal defect in Chinese with aortic valve prolapse and aortic regurgitation. Heart Vessels 1981; 2: 111-6.
8.Kobayashi J, Koike K, Senzaki H, Kobayashi T, Trunemoto M, Ishizawa A, et al. Correlation of anatomic and hemodynamic features wtih aortic valve leaflet deformity in doubly committed subarterial ventricular septal defect. Heart Vessels 1999; 14: 240-5.
9.Tomita H, Arakaki Y, Ono Y, Yamada O, Yagihara T, Echigo S. Imbalance of cusp width and aortic regurgitation associated with aortic cusp prolapse in ventricular septal defect. Jpn Circ J 2001; 65: 500-4.
10.Chiu SN, Wang JK, Lin MT, Wu ET, Lu FL, Chang CI, et al. Aortic valve prolapse associated with outlet-type ventricular septal defect. Ann Thorac Surg 2005; 79: 1366-71.
11.Pongiglione G, Freedom RM, Cook D, Rowe RD. Mechanism of acquired right ventricular outflow tract obstruction in patients with ventricular septal defect: an angiocardiographic study. Am J Cardiol 1982; 50: 776-80.
12.Zielinsky P, Rossi M, Haertel JC. Subaortic fibrous ridge and ventricular septal defect: role of septal malalignment. Circulation 1987; 75: 1124-9.
13.Corone P, Doyon F, Gaudeau S. Natural history of ventricular septal defect. A study involving 790 cases. Circulation 1977; 55: 908-15.
14.Perry GJ, Helmeke F, Nanda NC, Byard C, Soto B. Evaluation of aortic insufficiency by doppler color flow mapping. J Am Col Cardiol 1987; 9: 952-9.
15.Brauner R, Birk E, Blieden L, Sahar G, Vidne BA. Surgical management of ventricular septal defect with aortic valve prolapse: clinical considerations and results. Eur J Cardiothoracic Surg 1995; 9: 315-9.
16.Ando M, Takao A. Pathological anatomy of ventricular septal defect associated with aortic valve prolapse and regurgitation. Heart Vessels 1986; 2: 117-26.
17.Glen S, Burns J, Bloomfield P. Prevalence and development of additional cardiac abnormalities in 1448 patients with congenital ventricular septal defects. Heart 2004; 90: 1321-5.
Published
2016-01-26
Issue
Section
Original Articles
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
