| Behavior of unrepaired perimembranous ventricular septal defect in young adults. | |
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MedLine Citation:
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PMID: 20102957 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The number of adolescents and young adults with congenital heart defects, including ventricular septal defect (VSD), increases continuously. We evaluated the mid-term outcome of small and unclosed perimembranous VSDs (pmVSDs). All patients with a known unrepaired pmVSD at 16 years of age were selected from our database. The clinical, electrocardiographic, and echocardiographic changes between baseline and the latest follow-up examination were compared. A total of 220 patients (119 males, median age 18 years, interquartile range 7) could be included. During a median follow-up of 6 years (interquartile range 4, range 38), 2 patients died (1%; 1 from sudden death and 1 from end-stage heart failure). Endocarditis occurred in 8 patients (4%). One patient required pacemaker implantation (0.5%) and one required implantable cardioverter-defibrillator implantation (1%). Fifteen patients (7%) required a closing procedure. In 8 patients (4%), the pmVSD closed spontaneously. In the remaining 203 patients (93%), the QRS morphology changed in 5% and 1% lost sinus rhythm (p = 0.0001 and p = 0.015, respectively). The left ventricular ejection fraction and stroke volume index increased from 62 + or - 7% to 67 + or - 8% and from 41 + or - 11 to 44 + or - 15 ml/m(2) (p = 0.0001 and p = 0.035, respectively), the end-systolic diameter decreased, and the end-diastolic diameter did not change. Finally, patients with an open pmVSD developed more pulmonary arterial hypertension during follow-up (from 3% to 9%, p = 0.002). In conclusion, mid-term follow-up of adolescents and young adults with a small and unrepaired pmVSD was not uneventful. Some patients required intervention, but in others, spontaneous closure occurred. Electrocardiographic and structural changes were noticed, for which the clinical significance needs to be determined. |
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Authors:
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Veerle Soufflet; Alexander Van de Bruaene; Els Troost; Marc Gewillig; Philip Moons; Martijn C Post; Werner Budts |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2009-12-22 |
Journal Detail:
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Title: The American journal of cardiology Volume: 105 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-01-27 Completed Date: 2010-03-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 404-7 Citation Subset: AIM; IM |
Copyright Information:
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Copyright 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Cardiology and Pediatric Cardiology, University Hospitals Leuven, Belgium, Leuven. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Cardiac Surgical Procedures / methods Cohort Studies Defibrillators, Implantable Disease Progression Electrocardiography Female Follow-Up Studies Heart Catheterization Heart Failure / etiology, physiopathology Heart Septal Defects, Ventricular / complications, diagnosis, physiopathology*, therapy Heart-Assist Devices Humans Male Medical Records Pacemaker, Artificial Remission, Spontaneous Severity of Illness Index Stroke Volume Survival Analysis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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