Echocardiographic evaluation of ventricular septal defects

Nayak, Srishti; Patel, Akash; Haddad, Lana; Kanakriyeh, Mohammad S.; Varadarajan, Padmini

doi:10.1111/echo.14511

Cited by 11 publications

(6 citation statements)

References 14 publications

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“…Furthermore, it helps determine the hemodynamic status including the direction of flow across the defect, flow magnitude, peak gradient and also evaluate for other congenital abnormalities such as coaptation of the aorta, valvular pathologies and others that may be associated with the VSD. 41 Our patient had VSD together with rheumatic mitral regurgitation that was diagnosed with a transthoracic echocardiography. Cardiac catheterization also provides additional information concerning the hemodynamics, and gives accurate pulmonary artery pressure measurements including the PCWP 42 , 43 which would have been important in our case as it may have objectively shown the contribution of the left heart dysfunction (from the severe mitral regurgitation and systolic dysfunction) to the pulmonary hypertension.…”

Section: Discussionmentioning

confidence: 70%

Severe Pulmonary Hypertension From Combined Ventricular Septal Defect and Rheumatic MIitral Valve Disease: A Case Report and Literature Review

Owusu,

Amponsah,

Wiafe

2024

Clin Med Insights Case Rep

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Most individuals with ventricular septal defect survive to adulthood which allows time for other complications such as pulmonary arterial hypertension to gradually develop over a period of time. When there are other associated cardiac conditions that also contribute to the development of pulmonary hypertension such as valvular heart disease, the pulmonary hypertension may be exaggerated. Because these different etiologies of the pulmonary hypertension have different mechanisms, their coexistence can complicate patient management. We present a 26-year-old man with a large ventricular septal defect and rheumatic mitral valve disease who developed severe pulmonary hypertension that became complicated by atrial fibrillation and later sudden cardiac death.

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Section: Discussionmentioning

confidence: 70%

Severe Pulmonary Hypertension From Combined Ventricular Septal Defect and Rheumatic MIitral Valve Disease: A Case Report and Literature Review

Owusu,

Amponsah,

Wiafe

2024

Clin Med Insights Case Rep

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“…Peri-membranous VSDs are typically located near the subaortic outflow LVOT as well as AV and septal leaflet of tricuspid (TV) and thus may be associated with TV or AV abnormalities. 4 VSDs can also lead to AV-prolapse (AVP) and associated regurgitation, known as Laubry-Pezzi syndrome, with the mechanism being chronic venturi effect from VSD flow coupled with reduced support from RCC of the AV. 5,6 VSDs have known to be associated with infective endocarditis (IE).…”

Section: Discussionmentioning

confidence: 99%

Abnormal Color Flow Jet in Left Ventricular Outflow Tract Mimicking a Ventricular Septal Defect: Establishing Differentials and Diagnosis and Role of Transesophageal Echocardiography

Elliott,

Abraham,

Arain

2024

A&A Practice

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“…Both the shunt according to Fick cardiac output measurements and oximeter diagnostics are known to be steady-state methods. Therefore, the manual recommends taking a blood sample as soon as possible for “running the oximeter” [ 17 , 18 ]. However, if systemic circulation fluctuates during the time the blood sample is taken, the venous saturation level can change significantly as the tissue regulates oxygen extraction to maintain oxygen supply.…”

Section: Discussionmentioning

confidence: 99%

Detecting and Quantifying Residual Intracardiac Shunts Using Oximetric Step-Up Methods: A Prospective Observational Study

Bhende¹,

Sharma²,

Sharma³

et al. 2023

Cureus

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Background & aims Intracardiac shunts are abnormal channels of blood circulation within the heart that develop either as an additional blood flow pathway or as a replacement for the normal channels of blood circulation. They are the commonest types of congenital heart defects. Various methods are available in the present times to identify, localize or quantify left-to-right intracardiac shunts. Methods may vary in sensitivity, indicators, or types of equipment available. One such method used in almost all cardiac centers for a long time has been oximetry run to detect step-up differences in oxygen saturation values. In the oximetry run the main approach to detect and estimate the left-to-right (L-->R) shunts requires the oxygen concentration expressed as a proportion of saturation to be evaluated in blood samples which are obtained from the right atrium (RA) and pulmonary artery (PA), respectively. A left-to-right shunt can be considered if there is a significant increase (step-up) in blood saturation. A significant step-up is defined as a substantial rise in blood oxygen content or saturation that is higher than normal values. Methods Using a prospective observational design, this article investigates the application of the step-up method in detecting intracardiac shunts. The study was conducted between 2021 and 2022 on 35 pediatric cardiac patients (males/females, 24/11) diagnosed with post-tricuspid shunts. The pulmonary artery and right atrium were sampled before and after cardiopulmonary bypass surgery and analyzed using a blood gas test. As a result, nearly 91% of the patients had a saturation below 8%. However, the difference between PA oxygen saturation (SO 2) & RASO 2 before and after surgery was significant. As a result, the difference in O 2 saturation helped detect the residual ventricular septal defect (VSD) after the surgery. Results There were no deaths or complications in this study. There were no re-interventions for post-tricuspid shunt surgery, though one patient had a step-up of >15% and residual VSD status was moderate to large on two-dimensional (2D) echocardiography. Conclusion A combination of physical findings, chest radiography, electrocardiogram (ECG), and echocardiography is routinely done for all these patients undergoing pediatric cardiac surgery. Echocardiography can detect the occurrence of shunt but does not calculate the shunt ratio. Transesophageal or epicardial echocardiography is the standard of care but has its limitations like perception difference between the operating surgeon and the person performing echocardiography. In this study, we have added an oximetry analysis of blood-gas samples before and after surgery and compared it to 2D echocardiography to test the validation of oximetry in isolation and comparison to 2D echocardiography.

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Echocardiographic evaluation of ventricular septal defects

Cited by 11 publications

References 14 publications

Severe Pulmonary Hypertension From Combined Ventricular Septal Defect and Rheumatic MIitral Valve Disease: A Case Report and Literature Review

Severe Pulmonary Hypertension From Combined Ventricular Septal Defect and Rheumatic MIitral Valve Disease: A Case Report and Literature Review

Abnormal Color Flow Jet in Left Ventricular Outflow Tract Mimicking a Ventricular Septal Defect: Establishing Differentials and Diagnosis and Role of Transesophageal Echocardiography

Detecting and Quantifying Residual Intracardiac Shunts Using Oximetric Step-Up Methods: A Prospective Observational Study

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