Implication of aneurysmal transformation in isolated perimembranous ventricular septal defect
Journal
The American Journal of Cardiology
Journal Volume
72
Journal Issue
7
Pages
596-601
Date Issued
1993
Author(s)
Abstract
Defects on the membranous ventricular septum (perimembranous ventricular septal defect [VSD]) may spontaneously close or diminish in size by "aneurysmal transformation" (i.e., adherence of the tricuspid valve or adjacent tissue onto the VSD). It was recently shown that the appearance of aneurysmal transformation may be associated with subaortic ridges, as well as left ventricular (LV)-to-right atrial (RA) shunts. In all, 877 consecutive patients with isolated perimembranous VSD were retrospectively studied. Results of actuarial analysis showed that patients with a perimembranous VSD had a 98% probability of aneurysmal transformation by the age of 240 months. Of these patients, the expected probabilities of developing LV-RA shunt, spontaneous closure and subaortic ridge were 45, 35 and 6%, respectively. Patients with LV-RA shunts had higher probabilities of developing infective endocarditis (p = 0.002) and persistent left-to-right shunts (p < 0.001). The presence of a subaortic ridge may be accompanied by LV outflow tract obstruction (10 of 25 patients), infundibular pulmonary stenosis (n = 3), or aortic valve deformity or aortic regurgitation (n = 5), and none of those with a subaortic ridge closed spontaneously. It was confirmed that a substantial proportion of aneurysmal transformation of isolated perimembranous VSD is associated with LV-RA shunts and subaortic ridges. ? 1993.
SDGs
Other Subjects
aneurysm; angiocardiography; article; child; clinical feature; disease course; echocardiography; follow up; heart catheterization; heart left ventricle outflow tract obstruction; heart surgery; heart ventricle septum defect; human; infant; major clinical study; priority journal; statistical analysis; Actuarial Analysis; Age Factors; Child; Child, Preschool; Echocardiography; Follow-Up Studies; Heart Aneurysm; Heart Septal Defects, Ventricular; Human; Infant; Infant, Newborn; Life Tables; Probability; Remission, Spontaneous; Retrospective Studies
Type
journal article