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Pattern of ventricular septal defects and associated complications

Uzma Kazmi1, Masood Sadiq, Syed Najam Hyder

  • 1Department of Paediatric Cardiology, The Children's Hospital and Institute of Child Health, Lahore. druzmakazmi@yahoo.com

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|June 3, 2009
PubMed

Insights

Perimembranous Ventricular Septal Defect (VSD) is the most common type in Pakistan. Aortic valve prolapse and regurgitation are frequent complications, particularly with perimembranous VSDs, impacting patient management.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Echocardiography

Background:

  • Ventricular Septal Defect (VSD) is a common congenital heart anomaly.
  • Understanding the prevalence and types of VSD is crucial for effective management.
  • Complications associated with different VSD types require careful evaluation.

Purpose of the Study:

  • To determine the frequency of various Ventricular Septal Defect (VSD) types in a local pediatric population.
  • To identify and analyze the complications associated with different VSD subtypes.
  • To provide data relevant to the management of VSDs in Pakistan.

Main Methods:

  • A case series study was conducted at a Paediatric Cardiac Unit in Lahore.
  • 854 pediatric patients (1 day to 18 years) with isolated VSD were evaluated.
  • Transthoracic echocardiography (2-D, continuous wave Doppler, color Doppler) was the primary diagnostic tool, supplemented by transesophageal echocardiography and angiography when needed.

Main Results:

  • Perimembranous VSD was the most frequent type (83.1%), followed by muscular (11.7%), doubly committed subarterial (DCSA) (2.9%), and inlet VSD (2.2%).
  • Aortic Valve Prolapse (AVP) occurred in 10.8% of patients, with 47.3% experiencing aortic regurgitation (AR).
  • AVP and AR were predominantly associated with perimembranous outlet VSDs, not DCSA VSDs. Four patients had right ventricular outflow tract obstruction, two with subacute bacterial endocarditis.

Conclusions:

  • Perimembranous VSD is the most common type encountered in this Pakistani tertiary care setting.
  • The high incidence of AVP and AR in perimembranous VSDs has significant clinical implications.
  • These findings are particularly relevant in Pakistan due to a large number of unoperated VSD cases.
Abstract

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