Bidirectional flow in congenital ventricular septal defect: A doppler echocardiographic study

Abstract

Summary:The purpose of this study was to demonstrate the value of combined two-dimensional and pulsed Doppler echocardiography (echo) in localizing and recording bidirectional flow in congenital ventricular septal defect. Eight children, aged 8 months to 16 years, with clinical signs of a ventricular septal defect, underwent twodimensional and pulsed Doppler echo study prior to cardiac catheterization. The ventricular septal defect was documented anatomically by two-dimensional echo in all eight patients. Flow patterns in systole and diastole through the ventricular septal defect and on both sides of the defect were carefully studied. In all eight children, systolic, high velocity, pathologic, left to right flow was documented when the sampling volume was positioned on the right ventricular side of the defect. When the sampling volume was positioned inside the defect, to and fro flow, left to right in systole and right to left in diastole, was observed. In children with moderate to large defects, the diastolic flow had a peak in early diastole. Increased pressure in the right ventricle over the left ventricle during the same period was demonstrated by cardiac catheterization and coincided with the Doppler flow. The direction of flow across the defect was affected by the size of the defect and the magnitude of the net shunt. Two-dimensional and pulsed echo Doppler were shown to be useful in demonstrating the ventricular septal defect and estimating its size and hemodynamic significance noninvasively .

The midterm effect of exercise capacity and quality of life in adult patients who underwent hybrid transthoracic device closure of ventricular septal defects

“…Although VSD is a congenital disease, it can be considered a chronic disease for some adult patients due to imperfect diagnosis and treatment conditions and insufficient attention. The hemodynamic changes caused by the long-term existence of congenital heart malformations also leads to structural changes in the heart to some extent [13]. The results of this study showed that some patients' left ventricular size before treatment was at the high limit of the normal value, which was associated with left-to-right shunt changes in cardiac blood flow caused by VSD.…”

Bidirectional Ventricular Septal Defect Shunt: Quantification Technique Using Stress Pulsed Wave Doppler Echocardiography

“…Volume assessment of shunt using VTI has been validated previously. 13 This study builds on clinical application of this methodology. However, we did not use intra-cardiac invasive measurements at rest/stress to justify our findings.…”

Bidirectional Dynamic Change in Shunt Flow Across a Small Ventricular Septal Defect in a Patient With a Left Ventricular Assist Device

“…Tasuku Sato, MS 1) , Toru Hashimoto, MD, PhD 2,4) *, Yusuke Ishikawa, MD 2) , Takeo Fujino, MD, PhD 2) , Ichiro Sakamoto, MD 2) , Taiki Higo, MD 2) , Akira Shiose, MD, PhD 1,3) , Hiroyuki Tsutsui, MD, PhD 2)…”

“…It has been reported that to-and-fro or R-L shunt in diastole was documented in some patients with VSD, who had large VSD or were accompanied by severe pulmonary hypertension. 4,5 The finding of continuous R-L shunt across morphologically small VSD without advanced pulmonary hypertension might be unique to patients with LVAD.…”