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 ◽  
...  

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.

2017 ◽  
Vol 27 (7) ◽  
pp. 1437-1440
Author(s):  
Bhavik Champaneri ◽  
Mahesh Kappanayil ◽  
Raman K. Kumar

AbstractCatheter closure of membranous ventricular septal defects is generally not considered feasible in small infants. We report the successful closure of a membranous ventricular septal defect in a 1.8-kg infant with bilateral femoral artery occlusion using Amplatzer Duct Occluder II additional size device. The ventricular septal defect was crossed from the right ventricle, and the device was deployed using transthoracic echocardiographic guidance.


1990 ◽  
Vol 7 (01) ◽  
pp. 57-61
Author(s):  
Eva Laraudogoitia ◽  
Alfonso Medina ◽  
Javier Goicolea ◽  
Armando Bethencourt ◽  
Ignacio Coello ◽  
...  

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Ria Nova ◽  
Sukman Tulus Putra ◽  
Siti Nurmaini ◽  
Radiyati Umi Partan

Cardiac septal defect in children is one of the congenital heart defects characterized by atrial septal defects (ASD), ventricular septal defects (VSD) and defects in both atrial and ventricular septum (AVSD). The hemodynamic changes that occur are caused by a left to the right shunt. Differences in location, size of the defect and pulmonary vascular resistance make hemodynamic differences and clinical manifestations between the three types of cardiac septal defects. Detection of cardiac septal defects can be done by clinical examination by listening to the characteristic heart sounds and murmurs for each defect. However, clinical examination alone is often still difficult to determine the type of cardiac septal defect so that several supporting examinations such as photothorax, ECG, echocardiogram and cardiac catheterization need to be done to help establish the diagnosis.


2021 ◽  
Vol 5 (6) ◽  
pp. 608-613
Author(s):  
Ria Nova ◽  
Sukman Tulus Putra ◽  
Siti Nurmaini ◽  
Radiyati Umi Partan

Cardiac septal defect in children is one of the congenital heart defects characterized by atrial septal defects (ASD), ventricular septal defects (VSD) and defects in both atrial and ventricular septum (AVSD). The hemodynamic changes that occur are caused by a left to the right shunt. Differences in location, size of the defect and pulmonary vascular resistance make hemodynamic differences and clinical manifestations between the three types of cardiac septal defects. Detection of cardiac septal defects can be done by clinical examination by listening to the characteristic heart sounds and murmurs for each defect. However, clinical examination alone is often still difficult to determine the type of cardiac septal defect so that several supporting examinations such as photothorax, ECG, echocardiogram and cardiac catheterization need to be done to help establish the diagnosis.


1994 ◽  
Vol 4 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Jou-Kou Wang ◽  
Hung-Chi Lue ◽  
Mei-Hwan Wu ◽  
Ming-Lon Young ◽  
Ing-Sh Chiu ◽  
...  

SummaryA total of 80 patients, diagnosed by echocardiography as having ventricular septal defect with aortic valvar prolapse, underwent cardiac catheterization and surgery. Echocardiographic and angiographic results were compared with surgical findings. The ventricular septal defects as observed during surgery were found to be doubly committed and subarterial in 49 (61%), muscular outlet in 10 (13%), and perimembranous in 21(26%). The location had been erroneously categorized by echocardiography and angiography in 12 (15%) and in 15 (19%) patients, respectively. Prolapse of the right coronary leaflet of the aortic valve, as documented by echocardiography, was confirmed by angiography in all but two cases. Prolapse of the noncoronary leaflet was detected by both imaging modalities in three patients. Prolapse of the right coronary and noncoronary leaflets was observed at surgery in 49 and three patients, respectively. The mean size of the ventricular septal defect, when measured by echocardiography, was significantly smaller than that found following surgical measurements (3.3±1.3 vs 8.4±3.8 mm, p<0.001). Our study showed that the ventricular septal defect was erroneously classified in the presence of prolapse of the aortic valve in 15% and 19% of our cases by echocardiography and angiography, respectively. The herniated sinus of Valsalva forming the “roof” of the ventricular septal defect probably redirected the jet across the defect to cause the errors in interpretation. Echocardiography, nevertheless, is as reliable as angiography in our hands in the follow-up of patients with ventricular septal defect opening to the outlet of the right ventricle.


2015 ◽  
Vol 26 (2) ◽  
pp. 269-279 ◽  
Author(s):  
Angelo Restivo ◽  
Cira R. T. di Gioia ◽  
Robert H. Anderson ◽  
Raffaella Carletti ◽  
Pietro Gallo

AbstractWe studied 11 autopsied cases of the Eisenmenger malformation, comparing the findings with 11 hearts with intact ventricular septal structures, and nine hearts having perimembranous ventricular septal defects in the absence of aortic overriding. We found variable lengths for the subpulmonary infundibulum in the hearts with Eisenmenger defects. It was well developed in three hearts, of intermediate length in seven, and very short in one of the specimens. The muscular outlet septum was also of variable length compared with the free-standing subpulmonary infundibular sleeve. Except for one, all hearts had fibrous continuity between the aortic and tricuspid valvar leaflets, such that the ventricular septal defect was then perimembranous. In the remaining case, there was a completely subaortic muscular infundibulum, with the ventricular septal defect showing only muscular borders. The medial papillary muscle was absent in the majority of cases, but was well formed in three hearts, all with relatively short muscular outlet septums. We identified mild, intermediate, and severe degrees of rightward rotation of the aortic valve, and these findings correlated with the extent of aortic valvar overriding. In nine of the 11 hearts, the ventriculo-arterial connections were concordant, but there was double-outlet from the right ventricle in the other two specimens. Based on our anatomic and morphometric observations, we conclude that the hearts we have defined as having Eisenmenger defects show marked individual variation in their specific phenotypic anatomy.


2017 ◽  
Vol 29 (4) ◽  
pp. 583-585 ◽  
Author(s):  
Timothy K. Cooper

Ventricular septal defects are one of the most common congenital cardiac malformations in animals, and most often affect the membranous portion of the septum. These defects may rarely close spontaneously. An adult male black-tailed prairie dog ( Cynomys ludovicianus) had a smooth shiny botryoid red mass arising from the area of the septal cusp of the right atrioventricular (tricuspid) valve and membranous interventricular septum, and bulging into the right ventricular lumen. Histology and special staining demonstrated a membranous ventricular septal defect closed by the adherence of the septal cusp of the tricuspid valve to the muscular septum (so-called membranous ventricular septal aneurysm or aneurysm of the [peri]membranous ventricular septum). This is a rare finding in animals, and the histologic appearance has not been documented previously, to our knowledge.


2021 ◽  
Vol 36 (2) ◽  
pp. 148-152
Author(s):  
Mohamed Thabet Ali ◽  
Faiza Mohamed Ali

This study aimed to evaluate the incidence and spontaneous closure of ventricular septal defects in a randomly selected newborn population, using color Doppler echocardiographic screening. Color flow Doppler echocardiographic screening was performed in 635 neonates within the first week of life. Patients with a ventricular septal defect were also followed up for 6 months to detect spontaneous closure rate and its timing. The incidences of a ventricular septal defect in all neonates, preterm neonates, and term neonates were found as 48.8/1,000, 64/1,000, and 48.1/1,000 live births, respectively. Only three patients were symptomatic. 21 cases had a muscular ventricular septal defect and 10 cases had a perimembranous ventricular septal defect. Most of them had a small ventricular septal defect (≤3 mm). Spontaneous closure was observed in 64.5% of ventricular septal defects within 6 months Closure rate was found as 80% for preterm infants and 66.8% for term infants (p>0.05). The incidence of a ventricular septal defect was considerably high in neonates when routine color flow Doppler echocardiographic examination was performed. Despite the increased incidence of ventricular septal defect, spontaneous closure rate was remarkably high within the first 6 months of life. These defects may result from delayed physiologic development and have a good prognosis.


2021 ◽  
pp. 021849232110264
Author(s):  
Puneet Varma ◽  
Bharath A Paraswanath ◽  
Anand Subramanian ◽  
Jayaranganath Mahimarangaiah

Ventricular septal defects are increasingly being closed by transcatheter technique, with lesser morbidity and shorter hospital stay compared to open heart surgery. We report a case of embolization of a duct occluder deployed in a posterior muscular septal defect. The rare site of embolization necessitated an unusual approach for retrieval prior to subsequent closure using a double-disc device.


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