Document Detail


Behavior of unrepaired perimembranous ventricular septal defect in young adults.
MedLine Citation:
PMID:  20102957     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Veerle Soufflet; Alexander Van de Bruaene; Els Troost; Marc Gewillig; Philip Moons; Martijn C Post; Werner Budts
Related Documents :
4009927 - Left ventricular diastolic pressure-volume and stress-strain relationship in children.
17574987 - Can lv dyssynchrony as assessed with phase analysis on gated myocardial perfusion spect...
10492367 - Bmipp imaging to improve the value of sestamibi scintigraphy for predicting functional ...
9415937 - Left ventricular morphology in chronic renal failure by echocardiography.
11081257 - Characterization of thyroid-stimulating blocking antibodies that appeared during transi...
20579647 - In vivo visualization of trophozoites in patients with amoebic colitis by using a newly...
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-12-22
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-27     Completed Date:  2010-03-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  404-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Cardiology and Pediatric Cardiology, University Hospitals Leuven, Belgium, Leuven.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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


Previous Document:  Exercise performance and activity level in children with transposition of the great arteries treated...
Next Document:  Retinal vascular patterns after operative repair of aortic isthmic coarctation.