Clinical Significance of Simple Ventricular Septal Defect

Park, Chang Ro; Hyun, Myung Chul; Lee, Sang Bum

Abstract

PURPOSE: To investigate the clinical significance and frequency of simple VSD by location of the defect and hemodynamic severity.
METHODS
We studied 482 cases who were diagnosed as simple VSD at department of Pediatrics, Kyung Pook University Hospital between December 1983 and July 1993. All cases were diagnosed by 2 dimensional echocardiography and cardiac catheterization was done in 256 cases.
RESULTS
Overall VSD location was distributed as followings: Membranous 358(74.3%), subarterial 84(17.4%), muscular 33(6.8%) and malalignment 7(1.5%). According to the hemodynamic classification of Kidd and Keith, we categorized 256 cases who were undergone cardiac catheterization: Group I was 203 cases(79.3%), being membranous 145(71%), subarterial 50(25%) and muscular 8(4%), group II 17 cases(6.6%), being membranous 12(71%) and subarterial 5(29%), group III 12 cases(4.7%), being membranous 11(91%) and malalignment 1(8%), group IV 11 cases(4.3%), being membranous 5(45.4%), subarterial 3(27.3%) and malalignment 3(27.3%), group V 10 cases (3.9%), being membranous 7, subarterial 2 and muscular 1, and group VI 3 cases(1.2%), being subarterial 2 and malalignment 1. In 21 cases(4.4%), aortic valvular prolapses were developed, being subarterial 16 (76.2%), membranous 4(19%) and muscular 1(4.7%). In 6 cases categorized as group I, aortic regurgitation were developed, being membranous 4, subarterial 1 and muscular 1. There were 5 operative death, whom all were belong to group III or above.
CONCLUSIONS
The location of VSDs was distributed as followings: Membranous 73.4%, subarterial 17.4%, muscular 6.8% and malalignment 1.5%. And subarterial and malalignment VSD were more frequently accompanied with poor prognostic result in terms of hemodynamic severity.