Two-dimensional echocardiographic assessment of surgically closed ventricular septal defect

One hundred twenty patients operated on for closure of a ventricular septal defect (VSD) had postoperative assessment by 2-dimensional echocardiography. The presence of persistent "drop-out" between ventricular septum (VS) and the periphery of the "patch" was considered a sign of detachment and residual shunt. Echocardiographic findings of intact VS or residual VSD were correlated with angiographic findings in 30 patients and with clinical signs in 90 patients. Minute shunts with increased flow ratios less than 1.5:1 were occasionally missed. Persistent small drop-out was sometimes wrongly diagnosed as residual shunt when the patch was in an angled position and in the early postoperative weeks when peripatch edema of the VS suggested drop-out. Thus, 2-dimensional echocardiography is a reliable method for assessing significant persistent ventricular shunts and intact VS after surgical closure of a VSD.