Clarifying the Surgical Morphology of Inlet Ventricular Septal Defects (original) (raw)
Atrioventricular septal defect: Quantitative anatomy of the left ventricle
Pediatric Cardiology, 1996
A morphometric study was performed in 18 human hearts with atrioventricular septal defect not associated with other anomalies; 16 hearts had common atrioventricular orifices, and 2 presented separate right and left atrioventricular orifices. A total of eight parameters were analyzed, characterizing ventricular wall thickness, length and circumference of the inflow and outflow tracts, and circumference of the left orifice and aortic orifice. The data were compared with previously published patterns of normality. In addition, the volume of the aortic outflow tract was calculated. The inflow tract was shorter than the outflow tract, and the length of the diaphragmatic wall was equal to the sum of the lengths of the inflow tract and ventricular wall thickness at the level of the apex.
Anatomy of Atrial and Ventricular Septal Defects
Journal of Interventional Cardiology, 2000
The anatomy of atrial and ventricular septal defects is reviewed with reference to the normal cardiac septum. Owing to the limited extent of the atrial septum, true septal defects are confined to the area of the oval fossa. The sinus venosus and coronary sinus defects are interatrial communications being outside the conjhes of the atrial septum and close to important atrial structures. The description of ventricular septal defects as perimembranous, muscular and doubly committed, and juxtaarterial defects highlights the anatomy of the margins, the location, and proximity to the conduction system and valvar structures. Malalignment of septal structures can complicate the anatomy of ventricular septal defects producing inlet or outlet obstruction. (J Interven Cardiol2000; 13:475-486)
Heart, 1989
The cross sectional echocardiograms of 150 children with atrioventricular septal defects were reviewed to determine the spatial orientation of the ventricles. In 125 cases with usual atrial arrangement (situs solitus), ventricular topology showed the right hand pattem. Of the 25 patients with atrial isomerism, 13 had similar right hand topology but 12 (48%) had the left hand pattern. This finding was more common in hearts in the right side of the chest (dextrocardia), but there was no significant correlation between ventricular topology and number of atrioventricular valves or the ventriculoarterial connection. In part because of inferences for disposition of the conducting tissue, knowledge of ventricular topology is important when operation for atrioventricular septal defects is considered. Ventricular topology can be promptly recognised by cross sectional echocardiography.
Ventricular septal defect with normally connected and with transposed great arteries
The American Journal of Cardiology, 1986
The morphologic characteristics of 50 hearts with ventricular septal defect (VW) and ventriculoarterial (VA) discordance were compared with those of 105 hearts with VSD and VA concordance. Df the 7 VSD types in VA concordant hearts, the 3 that occur most frequently-central muscular (26%), perimembranous with leftward malalignment of the outlet septum (18 % ) and perimembranous with overriding posterior artery (15 % )-were absent in VA discordant hearts. of the 6 with VA discordance, 2 principal VSD types (perimembranous with rightward outlet septum malalignment [ 25 % ] and muscular infundibular with leftward outlet septum malalignment [ 15 % 1) did not occur in VA concordant
Annals of Thoracic Surgery, 2004
This study investigated changes in left ventricular (LV) geometry and systolic function after corrective surgery for atrial (ASD) and ventricular septal defects (VSD).Transesophageal LV short-axis echocardiograms were recorded before and after operative repair of ASD (n = 11) and VSD (n = 7). Preload was measured using LV end-diastolic area indexed for body surface area. Measurements of septal-freewall (D1) and anterior-posterior (D2) endocardial diameters were used to assess LV symmetry from D1/D2. Systolic indices included stroke area, area ejection fraction, and fractional shortening.Preload, stroke area, area ejection fraction, and fractional shortening of D1 increased after ASD repair but decreased after VSD repair (p < 0.05). End-diastolic symmetry increased after ASD closure and decreased after VSD closure (p < 0.05). Increases in stroke area and ejection fraction after ASD correction primarily reflected increased shortening of D1. A positive correlation was found overall between percent change in end-diastolic area (EDA) and percent change in area ejection fraction (r2 = 0.80, p < 0.0001, n = 18).Preload was the primary determinant of changes in LV function in this series of ASD and VSD repairs. Intraoperative changes in position of the interventricular septum affected systolic and diastolic LV symmetry and septal free wall shortening. Additional studies are needed to define changes in afterload and contractility as well as diastolic compliance and systolic mechanics.
Pathophysiology, Investigations, and Management of Ventricular Septal Defect
Zenodo (CERN European Organization for Nuclear Research), 2021
Background: Ventricular septal defects (VSDs) are still one of the most prevalent surgical indications in newborns and children with congenital heart disease. With advances in echocardiography, cardiac catheterization is no longer necessary in the treatment of these individuals. Although perioperative mortality and morbidity for isolated defects are still low, unique scenarios such as surgical care of numerous VSDs and decision-making in patients with pulmonary hypertension remain difficult. This chapter examines both classic and recent evidence that has shaped the management of this condition, as well as the facts underlying developing interventional methods utilized in both the catheterization lab and the operating room. Conclusion: VSD is the most common congenital abnormality at birth. Small flaws should close on their own within the first year of life; however, larger faults can cause serious difficulties. The major interventions for big problems are surgical VSD closure and device closure.