Related Experiment Videos
Echocardiographic evaluation of aortic cusp prolapse in children with ventricular septal defect
Insights
Children with ventricular septal defect and aortic cusp prolapse show a significantly increased aortic root diameter. An aortic root diameter over 120% of normal suggests prolapse, aiding in diagnosis.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Congenital Heart Disease
Background:
- Ventricular septal defect (VSD) is a common congenital heart anomaly.
- Aortic cusp prolapse can be a complication of VSD, potentially leading to complications.
- Non-invasive diagnostic methods are crucial for evaluating VSD-related complications.
Purpose of the Study:
- To quantitatively and qualitatively assess aortic cusp prolapse in children with VSD using echocardiography.
- To establish echocardiographic criteria for identifying aortic cusp prolapse in this population.
Main Methods:
- Echocardiograms were performed on 48 Japanese children with VSD.
- Patients were divided into two groups: 16 with aortic cusp prolapse (Group I) and 32 without (Group II).
- Aortic root diameter was measured and expressed as a percentage of normal; aortic and pulmonary valve dynamics were also assessed.
Main Results:
- Group I showed a significantly larger aortic root diameter (131% ± 9%) compared to Group II (105% ± 7%) (p < 0.001).
- 14 out of 16 patients in Group I had an aortic root diameter >120%, while all in Group II were <120%.
- Systolic semiclosure of the aortic valve and coarse systolic fluttering of the pulmonary valve were more frequent in Group I.
Conclusions:
- An aortic root diameter exceeding 120% of normal is a strong indicator of aortic cusp prolapse in children with VSD.
- Echocardiographic findings like aortic valve semiclosure and pulmonary valve fluttering can qualitatively support the diagnosis of aortic cusp prolapse.
Abstract:
Echocardiograms were obtained from 48 Japanese children with ventricular septal defect (16 having aortic cusp prolapse, Group I, and 32 without it, Group II). In the case of right coronary cusp prolapse, the right coronary sinus protrudes anteriorly into the right ventricular outflow tract, and thus, the anteroposterior diameter of the aortic root increases. In the case of non-coronary cusp prolapse, the non-coronary sinus bulges posteriorly into the right ventricle, and thus, the aortic root increases in size. For evaluating the degree of these prolapses quantitatively, we measured the aortic root diameter echocardiographically and expressed them as a percent of a normal one. In Group I the aortic root diameter was 131 +/- 9% (mean +/- SD) and in Group II it was 105 +/- 7%, and the difference between the 2 groups was statistically significant (p less than 0.001). In Group I 14 of the 16 patients had a value greater than 120%, while all 32 patients of Group II had a value smaller than 120%. Thus, in children with ventricular septal defect, an aortic root diameter greater than 120% of normal suggests the presence of aortic cusp prolapse. Systolic semiclosure of the aortic valve was found in 8 patients of Group I (50.0%) and in 2 of Group II (8.7%). Coarse systolic fluttering of the pulmonary valve with an amplitude of greater than 3 mm was detected in 6 of Group I (40.0%) and in 3 of Group II (10.0%). Therefore, semiclosure of the aortic valve and fluttering of the pulmonary valve are considered to be also useful for evaluating aortic cusp prolapse qualitatively.