Mechanism of acquired right ventricular outflow tract obstruction in patients with ventricular septal defect: An angiocardiographic study

Pongiglione, Giacomo; Freedom, Robert M.; Cook, David H.; Rowe, Richard D.

doi:10.1016/0002-9149(82)91233-4

Cited by 82 publications

(43 citation statements)

References 20 publications

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“…437 No genetic pattern has been identified, although it has been reported to develop in approximately 3% of patients with repaired tetralogy of Fallot and 3% to 10% of patients with an isolated VSD. 438,439 …”

Section: Definition and Associated Lesionsmentioning

confidence: 99%

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease

Warnes¹,

Williams²,

Bashore³

et al. 2008

Circulation

892

365

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Section: Definition and Associated Lesionsmentioning

confidence: 99%

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease

Warnes¹,

Williams²,

Bashore³

et al. 2008

Circulation

892

365

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“…It has been reported to develop in Ϸ3% of patients with repaired tetralogy of Fallot 101 and in 3% to 10% of patients with a VSD. 102 …”

Section: General Considerationsmentioning

confidence: 99%

Adult Congenital Heart Disease

Bashore

2007

Circulation

133

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It has variably been estimated that between 800 000 and 1 million patients with congenital heart disease are now adults and that by 2010 more patients older than 16 years will undergo surgery for congenital heart disease than those younger than 16 years. 1 This review will focus on the clinical aspects of identifying and caring for the portion of the unique population that have right ventricular (RV) outflow tract lesions. Clinical Morphology of the RV Outflow TractThe left ventricle (LV) and RV both have inlet, apical, and outlet portions, although they differ considerably. 2 The inlet of the RV includes the tricuspid valve, and it is separated from the pulmonary valve (PV) by the crista supraventricularis. This structure results in the PV being raised upward. The apical portion of the RV has coarse trabeculations. As shown in Figure 1, the septum is home to a large septomarginal (septal) trabeculation that divides into the anterior and posterior limbs in the outflow tract. A series of septoparietal trabeculations arise along the free wall. The crista supraventricularis inserts between these limbs and is made up of 3 components: the muscular outlet septum, the ventriculoinfundibular fold, and the inner curvature of the RV. 3 The small part that separates the RV and LV cavities is the outlet or conal septum. A loop including the septal trabeculation, the moderator band, septoparietal trabeculations, and the outlet septum can be conceptualized as circling the RV outflow tract. The PV is supported by the circular muscular infundibulum rising outside the RV proper. Abnormalities involving the RV outflow tract involve malpositioning of 1 or more of these structures.

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“…A systolic PAP ≤25 mmHg was considered normal. [13][14][15] If no adequate Doppler signal of the tricuspid regurgitant flow could be obtained, PAP was calculated by subtracting the left ventricular to right ventricular systolic gradient (LV-RV gradient) from the systemic arterial pressure measured with cuff, provided that no aortic stenosis was present. 15 …”

Section: Echocardiographymentioning

confidence: 99%

Small Ventricular Septal Defect Considered Not Requiring Surgical Closure: The Frequency of Developing Complications in Our Center

Hyder¹,

Kazmi²,

Kazmi³

2016

Heart Res Open J

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Objectives:The study was conducted to check the frequency of development of complication in the patients with small Ventricular Septal Defects (VSDs) considered not requiring surgical closure during childhood. Methods: A descriptive study was conducted on children from January 2015 to December 2015 at Children Hospital and Institute of Child Health, Lahore, Pakistan. The data with isolated VSDs considered too small to require surgery from 1 month to 15 years of age were reviewed. The data was analyzed with SPSS 20 version. Results: The total of 883 patients of restrictive VSDs considered not to require surgery, 60.6% (n=535) were males and 39.4% (n=348) were females. The significant number of patients i.e. 18.7% (n=166) developed complications. Aortic cusp prolapsed developed in 13.6% i.e. p≤0.05, 2.3% developed aortic regurgitation secondary to aortic cusp prolapsed. 1.8% developed right ventricular track outflow obstruction (RVOT) i.e. p≤0.05 and 0.3% of patient developed left ventricular outflow track obstruction (LVOT) i.e. p≤0.05. Similarly 0.8% patients developed endocarditis. Regarding types of VSD, we found Perimembranous in 65.8%, muscular in 12.6%, Subaorticin 8.3%, doubly committed in 6.0%, Inlet in 5% and outlet in 1.7% of our patients. Conclusions: Patients with small restrictive Ventricular Septal Defects (VSDs) generally been considered as do not required surgery, the data suggested that a significant percentage of these patients developed complications later in their life i.e., 18.7%.

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Mechanism of acquired right ventricular outflow tract obstruction in patients with ventricular septal defect: An angiocardiographic study

Cited by 82 publications

References 20 publications

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease

Adult Congenital Heart Disease

Small Ventricular Septal Defect Considered Not Requiring Surgical Closure: The Frequency of Developing Complications in Our Center

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