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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Eisenmenger ventricular septal defect: classification, morphology, and indications for surgery.
Huiwen Chen1, Zhiwei Xu, Shunmin Wang
1Department of Heart Center, Shanghai Children Medical Center, Shanghai Jiao Tong University, 1678 Dongfang Road, Shanghai 200127, China. hwhwc@hotmail.com
Pediatric Cardiology
|November 17, 2010
Summary
Eisenmenger ventricular septal defect (EVSD) requires distinct definition and surgical approach. Early closure is crucial, with rare aortic regurgitation managed if moderate, and subpulmonary stenosis repaired via the tricuspid valve.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Eisenmenger ventricular septal defect (EVSD) is a complex congenital heart condition.
- Previous diagnoses often involved perimembranous ventricular septal defects (pVSD).
- Patients frequently presented with respiratory symptoms and growth issues.
Purpose of the Study:
- To define EVSD and its surgical indications.
- To investigate the causes of aortic regurgitation in EVSD.
- To understand the mechanisms of subpulmonary stenosis in EVSD.
Main Methods:
- Retrospective analysis of 160 patients with EVSD.
- Evaluation of preoperative symptoms, defect types, and associated anomalies.
- Assessment of aortic regurgitation and subpulmonary stenosis severity.
Main Results:
- 41% of patients had respiratory symptoms; 13% required ventilation.
- Aortic regurgitation occurred in 23% (mild/moderate), with subpulmonary stenosis and muscular rims as risk factors.
- Subpulmonary stenosis was present in 35% and repaired via the tricuspid valve.
Conclusions:
- EVSD should be recognized as distinct from pVSD and closed early, especially in developing nations.
- Aortic regurgitation is rare but requires intervention if moderate.
- Subpulmonary stenosis is manageable through tricuspid valve repair.
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