Clinical Significance of Simple Ventricular Septal Defect

ABSTRACT

PURPOSE: To investigate the clinical significance and frequency of simple VSD by location of the defect and hemodynamic severity. METHODS: We studied 482 cases who were diagnosed as simple VSD at department of Pediatrics, Kyung Pook University Hospital between December 1983 and July 1993. All cases were diagnosed by 2 dimensional echocardiography and cardiac catheterization was done in 256 cases. RESULTS: Overall VSD location was distributed as followings Membranous 358(74.3%), subarterial 84(17.4%), muscular 33(6.8%) and malalignment 7(1.5%). According to the hemodynamic classification of Kidd and Keith, we categorized 256 cases who were undergone cardiac catheterization Group I was 203 cases(79.3%), being membranous 145(71%), subarterial 50(25%) and muscular 8(4%), group II 17 cases(6.6%), being membranous 12(71%) and subarterial 5(29%), group III 12 cases(4.7%), being membranous 11(91%) and malalignment 1(8%), group IV 11 cases(4.3%), being membranous 5(45.4%), subarterial 3(27.3%) and malalignment 3(27.3%), group V 10 cases (3.9%), being membranous 7, subarterial 2 and muscular 1, and group VI 3 cases(1.2%), being subarterial 2 and malalignment 1. In 21 cases(4.4%), aortic valvular prolapses were developed, being subarterial 16 (76.2%), membranous 4(19%) and muscular 1(4.7%). In 6 cases categorized as group I, aortic regurgitation were developed, being membranous 4, subarterial 1 and muscular 1. There were 5 operative death, whom all were belong to group III or above. CONCLUSIONS: The location of VSDs was distributed as followings Membranous 73.4%, subarterial 17.4%, muscular 6.8% and malalignment 1.5%. And subarterial and malalignment VSD were more frequently accompanied with poor prognostic result in terms of hemodynamic severity.