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Anatomic characteristics of ventricular septal defect associated with coarctation of the aorta

R J Moene, A C Gittenberger-de Groot, A Oppenheimer-Dekker

    The American Journal of Cardiology
    |April 15, 1987
    PubMed

    Insights

    This study analyzed ventricular septal defects (VSDs) and left ventricular outflow tracts in 45 hearts with coarctation of the aorta (CoA). Most VSDs were muscular or perimembranous, with many showing potential for spontaneous closure.

    Area of Science:

    • Cardiovascular Pathology
    • Congenital Heart Defects
    • Pediatric Cardiology

    Background:

    • Coarctation of the aorta (CoA) is a congenital heart defect often associated with other cardiac anomalies.
    • Ventricular septal defects (VSDs) are common congenital heart abnormalities.
    • The relationship between VSD morphology and left ventricular outflow tract (LVOT) anomalies in CoA requires further elucidation.

    Purpose of the Study:

    • To characterize the morphologic features of VSDs and LVOT in hearts with coarctation of the aorta.
    • To classify VSDs into distinct categories based on their location and morphology.
    • To investigate the association between VSD types, LVOT anomalies, and the potential for spontaneous VSD closure.

    Main Methods:

    • Morphologic assessment of 45 hearts with VSD and CoA.
    • Classification of VSDs into four main categories based on location and septal involvement.
    • Detailed evaluation of the left ventricular outflow tract for associated anomalies.

    Main Results:

    • Forty-one VSDs were classified into central muscular (43%), perimembranous inlet (23%), perimembranous VSDs with leftward outlet septal malalignment (18%), and subarterial (8%) types.
    • Seventy percent of VSDs belonged to types with a high incidence of spontaneous closure (muscular, membranous inlet).
    • The left ventricular outflow tract was abnormal in 43 out of 45 cases, frequently involving anterolateral muscle bundle, anteroseptal twist, bicuspid aortic valve, or leftward malaligned outlet septum.

    Conclusions:

    • Specific VSD morphologies, particularly muscular and perimembranous inlet types, are prevalent in hearts with coarctation of the aorta and are associated with a high likelihood of spontaneous closure.
    • Anomalies of the left ventricular outflow tract are consistently present in hearts with VSD and coarctation of the aorta, supporting the hypothesis that these LVOT anomalies may hemodynamically induce CoA.
    • Understanding the interplay between VSD characteristics and LVOT anomalies is crucial for managing congenital heart disease in this patient population.

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