Prolonged Support with Intraaortic Balloon for Postinfarction Ventricular Septal Rupture

1994 ◽  
Vol 2 (2) ◽  
pp. 106-108
Author(s):  
Harinder Singh Bedi ◽  
Vijay Sharma ◽  
Vijay Kohli ◽  
Anil Mishra ◽  
Ashok Jayant ◽  
...  
Keyword(s):  
Septal Defect ◽  
Optimal Timing ◽  
Intraaortic Balloon ◽  
Ventricular Septal Rupture ◽  
Ventricular Septal Defects ◽  
Intraaortic Balloon Pump ◽  
Surgical Closure ◽  
Septal Defects ◽  
Early Closure ◽  
Postinfarction Ventricular Septal Rupture

The optimal timing of repair in postinfarct interventricular septal rupture remains controversial. We report a 53-year-old man with a postinfarct ventricular septal defect sustained on intraaortic balloon pump for 20 days before successful surgical closure. In the presence of proponents of routine early closure of postinfarct ventricular septal defects the possibility of prolonged intraaortic balloon pump support to stabilize the patient must be kept in mind.

Persistent electrical and morphological atrial abnormalities after early closure of atrial septal defect

2004 ◽  
Vol 14 (5) ◽  
pp. 481-487 ◽  
Author(s):  
Clifford L. Cua ◽  
Elizabeth E. Sparks ◽  
David P. Chan ◽  
Curt J. Daniels
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Pearson Correlation ◽  
P Wave ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Pr Interval ◽  
Early Closure ◽  
The Right

Atrial arrhythmias are associated with enlarged atrial chambers and an increased duration of the P wave. Repair of atrial defects within the oval fossa is expected to normalize atrial size. Few studies, however, have evaluated electrical and morphological atrial features after repair. Our study was performed to determine if atrial abnormalities exist after surgical closure of such atrial septal defects, and whether early closure improves outcome. We recruited patients who had undergone surgical closure of a defect within the oval fossa, so-called “secundum” atrial septal defects. Electrocardiograms, signal averaged electrocardiograms, and echocardiograms were performed. Two-tailed test and Pearson correlation was utilized for statistical analysis. The population consisted of 20 patients and 27 controls, with the mean age of the patient being 11.25 ± 5.10 years, their age at surgery 6.55 ± 5.10 years, and the time since surgery 4.70 ± 2.61 years. The size of the right (23.88 ± 6.35 ml/m2 versus 18.84 ± 4.43 ml/m2) and left (21.91 ± 12.47 ml/m2 versus 17.72 ± 4.83 ml/m2) atrium were significantly larger in the patients. The duration of the P wave (108 ± 16 ms versus 96 ± 8 ms) and the duration of the PR interval (155 ± 18 ms versus 138 ± 23 ms) were longer. No correlation existed between age or interval since surgery with atrial sizes or measurements of the signal averaged electrocardiogram. We conclude that, despite surgical repair, abnormalities exist in patients with an atrial septal defect. Early surgery does not appear to prevent the atrial abnormalities.

Large Congenital Ventricular Septal Defect: Surgical Closure at Sixty Years

1997 ◽  
Vol 5 (2) ◽  
pp. 124-126
Author(s):  
Mandeep Singh ◽  
Rajendar Krishan Suri ◽  
Neerod Kumar Jha ◽  
Rajnish Juneja ◽  
Harinder Kumar Bali ◽  
...  
Keyword(s):  
Natural History ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
The Elderly ◽  
Ventricular Septal Defects ◽  
Surgical Closure ◽  
Septal Defects

Large congenital ventricular septal defects have an unfavorable natural history and survival to 60 years of age with a large left-to-right shunt is very uncommon; surgical closure of such a defect in the elderly is even rarer. We report the case of a 60-year-old female who presented with a large left-to-right shunt across a congenital subaortic ventricular septal defect and underwent successful surgical closure.

Familial muscular ventricular septal defects and aneurysms of the muscular interventricular septum

2007 ◽  
Vol 17 (5) ◽  
pp. 523-527 ◽  
Author(s):  
Mugur I. Nicolae ◽  
Kim M. Summers ◽  
Dorothy J. Radford
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Autosomal Dominant ◽  
Interventricular Septum ◽  
Dominant Inheritance ◽  
Ventricular Septal Defects ◽  
Surgical Closure ◽  
Septal Defects ◽  
Precise Diagnosis ◽  
Echocardiographic Evidence

AbstractWe describe 3 siblings with muscular ventricular septal defects, two requiring surgical closure. One of their offspring had a rare congenital aneurysm of the muscular ventricular septum, also requiring surgery. Another had a small muscular ventricular septal defect which closed spontaneously. Their father had echocardiographic evidence suggestive of a closed muscular defect. Paternal cousins have had ventricular septal defect, hypertrophic cardiomyopathy, and tetralogy of Fallot. There was no evidence of 22q11 deletion.Although ventricular septal defects are the most common congenital heart defect, such familial clustering is uncommon. The distribution of cases in this family suggests autosomal dominant inheritance. With echocardiography, and more precise diagnosis of defects which close, a larger genetic component may be revealed in other families.

scholarly journals Closure of a large upper muscular ventricular septal defect in a 2.3 kg baby using a duct occluder

2021 ◽  
Vol 8 (3) ◽  
pp. 165-169
Author(s):  
Mirza Mohd Kamran ◽  
◽  
Shaad Abqari ◽  
Azam Haseen ◽  
Mayank Yadav ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Failure To Thrive ◽  
Ventricular Septal Defects ◽  
Device Closure ◽  
Weight Category ◽  
Surgical Closure ◽  
The Past ◽  
Septal Defects ◽  
Younger Age

Surgical closure of the ventricular septal defect is a time tested and well-accepted procedure to dateespecially in smaller babies with failure to thrive and severe pulmonary hypertension. Surgicalclosure is regarded as the gold standard treatment. However over the past 10 years percutaneoustrans-catheter device closure has emerged as a safer alternative especially in the case of muscularVSD. Transcatheter closure of ventricular septal defects (VSD) has not yet received generalacceptance. It is not well-established in the younger age group with a weight category of less than5kg. Occasionally, a hybrid procedure has been proposed. We believe that certain types of VSD canbe closed safely by the transcatheter approach even if weight is less than 5kg, especially if the trendof miniaturizing devices continues. This approach should be considered as a valid alternative to asurgical option. We are reporting such a VSD baby with a weight of 2.3 Kg at the age of 6 months,which was closed with a duct occluder

scholarly journals Spontaneous Resolution of Residual Shunting in 2 Compromised Patients after Amplatzer Occlusion of Postinfarction Ventricular Septal Defects

2019 ◽  
Vol 46 (1) ◽  
pp. 44-47
Author(s):  
Takashi Yanagiuchi ◽  
Norio Tada ◽  
Taro Suchi ◽  
Yukiko Mizutani ◽  
Takashi Matsumoto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Severe Heart Failure ◽  
Effective Management ◽  
Ventricular Septal Defects ◽  
Surgical Closure ◽  
Septal Defects ◽  
Gradual Disappearance ◽  
Intensively Managed

Ventricular septal defect (VSD) is a rare, potentially fatal complication of acute myocardial infarction. When surgical closure is contraindicated, transcatheter closure may be an alternative. Residual shunting after transcatheter closure of postinfarction VSDs has been reported; however, we found few cases of this in patients who also had severe heart failure or hemolysis. We report 2 closures of postinfarction VSDs with use of the Amplatzer Septal Occluder. Both elderly patients—one with severe heart failure, one with persistent hemolysis, and neither a surgical candidate—had high-velocity residual shunting through the occluders. We intensively managed the patients' conditions and used angiography and transthoracic echocardiography to record the gradual disappearance of each shunt over 4 months—the first such serial monitoring of which we are aware. We think that even substantial shunting in the presence of severe heart failure or hemolysis can eventually resolve spontaneously, assuming effective management of the concomitant medical conditions.

EARLY SURGICAL CORRECTION OF LARGE VENTRICULAR SEPTAL DEFECTS

PEDIATRICS ◽  
1967 ◽  
Vol 39 (1) ◽  
pp. 4-13
Author(s):  
Joan M. Sigmann ◽  
Aaron M. Stern ◽  
Herbert E. Sloan
Keyword(s):  
Pulmonary Hypertension ◽  
Septal Defect ◽  
Pulmonary Infections ◽  
Severe Pulmonary Hypertension ◽  
Ventricular Septal Defects ◽  
Specific Therapy ◽  
Surgical Closure ◽  
Early Correction ◽  
Septal Defects ◽  
Pulmonary Vascular Obstructive Disease

A significant number of babies born with large ventricular septal defects present early in life as problems in management of congestive heart failure, severe pulmonary hypertension, marked growth retardation, and recurrent pulmonary infections. Review of patients born since December 1954 with ventricular septal defects and followed at our institution allowed for comparison between infants treated surgically and those patients treated either medically or requiring no specific therapy. In 45 infants direct surgical closure of the ventricular defect was undertaken when supportive medical management alone appeared to be inadequate to insure survival or a normal life potential. There was an 80% survival with surgery. All 9 deaths occurred in patients having severe pulmonary hypertension; in some instances additional factors were believed to have contributed to the death of the infant. Nonetheless, surgical mortality appeared to be lower in the infants having severe pulmonary hypertension than among children with a comparable degree of hypertension who were operated on over the age of 2 years. Postmortem examination revealed pathologic changes of advanced pulmonary vascular obstructive disease at as early an age as 8 months. Direct surgical closure of the ventricular septal defect was chosen in preference to the pulmonary artery handing procedure because it not only offers an immediate means of helping the sick infant but also should obviate the necessity of a second major surgical procedure when the patient is older. It is further anticipated that early correction of the septal defect will prove effective in many instances in preventing the serious consequences of pulmonary hypertension.

Natural history of prenatal ventricular septal defects and their association with foetal echocardiographic features

2011 ◽  
Vol 22 (3) ◽  
pp. 323-326 ◽  
Author(s):  
Youpeng Jin ◽  
Aiyun Wang ◽  
Yulin Wang ◽  
Yuemei Wang ◽  
Wei Wang ◽  
...  
Keyword(s):  
Natural History ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
In Utero ◽  
Postnatal Period ◽  
Ventricular Septal Defects ◽  
Closure Rate ◽  
Septal Defects ◽  
Early Closure ◽  
Lost To Follow Up

AbstractObjectiveTo describe the evolution of ventricular septal defects in infants from intra-uterine diagnosis to the age of 3 years or until documented echocardiographic closure of the defect, as well as any relationship between closure rate, time and foetal echocardiographic features.MethodsBetween January, 2004 and December, 2006, 268 cases of congenital cardiac defect were detected in 14,993 pregnancies referred to our hospital for routine foetal echocardiography; of these cases, 125 had isolated ventricular septal defect. The mothers were scheduled for regular ultrasonography every 2 weeks from diagnosis until the ventricular septal defect closed or 3 years postnatally.ResultsOf the 125 cases of ventricular septal defects, the pregnancy was terminated in 25, four resulted in death, two defects closed spontaneously in utero, 55 closed at a mean age of 13.7 months postnatally, 17 were treated with surgery, nine remained unclosed, and 13 cases were lost to follow-up. Only 7.7% of muscular ventricular septal defects remained patent as compared with 35.7% of perimembranous ventricular septal defects (p is less than 0.01). Muscular ventricular septal defects closed earlier than perimembranous ventricular septal defects. All the ventricular septal defects less than or equal to 3 millimetres closed, whereas only 79.5% of the defects greater than 3 millimetres closed before the age of 3 years; 60.9% of the defects less than or equal to 3 millimetres closed before the age of 1 year as compared with 41.7% of the defects greater than 3 millimetres. The velocity of right-to-left flow was negatively correlated with closure rate but not related to closure period.ConclusionVentricular septal defects can close in utero or during the postnatal period, and both the size and site play a role in the natural history, with small and muscular ventricular septal defects having a high closure rate and early closure.

scholarly journals Unusual Hybrid Closure of Ventricular Septal Defects

2018 ◽  
Vol 11 (4) ◽  
pp. NP158-NP160
Author(s):  
Thomas Krasemann ◽  
Ingrid van Beynum ◽  
Pieter van de Woestijne
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Open Heart ◽  
Ventricular Septal Defects ◽  
Device Closure ◽  
Surgical Closure ◽  
Septal Defects ◽  
Perimembranous Ventricular Septal Defect ◽  
Patch Closure ◽  
Technical Fault

A planned combined perventricular and “open heart” surgical closure of multiple ventricular septal defects had to be modified intraoperatively due to a technical fault disabling echocardiographic guidance. Through an atriotomy, device closure of a muscular defect and patch closure of a perimembranous ventricular septal defect were performed. In unusual situations, collaboration of the surgical and interventional team is crucial.

Transcatheter closure of ventricular septal defects in children less than 10 kg: experience from a tertiary care referral hospital in Eastern India

2021 ◽  
pp. 1-7
Author(s):  
Mahua Roy ◽  
Debasree Gangopadhyay ◽  
Noopur Goyal ◽  
Savita Murthy ◽  
Debabrata Nandi ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Ventricular Septal Defects ◽  
Device Closure ◽  
Small Children ◽  
Surgical Closure ◽  
Septal Defects ◽  
Percutaneous Device ◽  
Transcatheter Device ◽  
Percutaneous Device Closure

Abstract Objective: To assess the feasibility of percutaneous transcatheter device closure of ventricular septal defects in children weighing less than 10 kg. Background: Although percutaneous transcatheter device closure of ventricular septal defect is a well-established method of treatment in older children and adolescents, there is limited data on device closure in small children weighing less than 10 kg. We present our institutional experience of transcatheter VSD closure in children weighing less than 10 kg. Method: Medical records were reviewed for 16 children, who were selected for device closure of ventricular septal defects based on the inclusion criteria. Results: Out of 65 patients with a diagnosis of ventricular septal defect, 16 children less than 10 kg were attempted for percutaneous device closure. In 13 patients, the device was successfully released, and 3 patients needed surgical closure of the defect. Mean age and weight of the patients were 17.3 ± 12.7 months and 6.8 ± 3.2 kg, respectively. Mean defect size was 6 mm (range 3–10). There was no incidence of device embolisation or heart block or death. Five patients had residual left-to-right shunt immediately after the device release, which got closed by the first month’s follow-up. We had one accidental perforation of right ventricular free wall at the time of crossing of the defect, which was successfully repaired surgically. Conclusion: Percutaneous device closure of ventricular septal defect in small children with weight below 10 kg is feasible with good short-term outcome. Careful patient selection is essential for procedural success and to avoid complications.

Delayed Closure of Multiple Muscular Ventricular Septal Defects in an Infant after Coarctation Repair and a Hybrid Procedure�A Case Report

2011 ◽  
Vol 14 (1) ◽  
pp. 67 ◽  
Author(s):  
Ireneusz Haponiuk ◽  
Maciej Chojnicki ◽  
Radosaw Jaworski ◽  
Jacek Juciski ◽  
Mariusz Steffek ◽  
...  
Keyword(s):  
Septal Defect ◽  
Color Doppler ◽  
Hybrid Approach ◽  
Ventricular Septal Defects ◽  
Color Doppler Echocardiography ◽  
Septal Defects ◽  
Coarctation Repair ◽  
Step Procedure ◽  
The Right ◽  
Delayed Closure

There are several strategies of surgical approach for the repair of multiple muscular ventricular septal defects (mVSDs), but none leads to a fully predictable, satisfactory therapeutic outcome in infants. We followed a concept of treating multiple mVSDs consisting of a hybrid approach based on intraoperative perventricular implantation of occluding devices. In this report, we describe a 2-step procedure consisting of a final hybrid approach for multiple mVSDs in the infant following initial coarctation repair with pulmonary artery banding in the newborn. At 7 months, sternotomy and debanding were performed, the right ventricle was punctured under transesophageal echocardiographic guidance, and the 8-mm device was implanted into the septal defect. Color Doppler echocardiography results showed complete closure of all VSDs by 11 months after surgery, probably via a mechanism of a localized inflammatory response reaction, ventricular septum growth, and implant endothelization.

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