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Ventricular dynamics after surgical closure of VSD
Scandinavian Journal of Thoracic and Cardiovascular Surgery
|January 1, 1980
Summary
Surgical closure of ventricular septal defects (VSD) can lead to postoperative ventricular dysfunction, indicated by prolonged pre-ejection periods, even with normalized hemodynamics. Conduction defects and altered ventricular compliance may contribute to these findings.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Ventricular septal defects (VSD) are common congenital heart abnormalities.
- Surgical closure is the standard treatment for VSD.
- Postoperative assessment of ventricular function is crucial.
Purpose of the Study:
- To evaluate long-term ventricular function after surgical VSD closure.
- To correlate echocardiographic findings with clinical and hemodynamic outcomes.
- To identify potential mechanisms of postoperative ventricular dysfunction.
Main Methods:
- Studied 20 patients (age 5-20) 2-9 years post-VSD closure.
- Utilized echocardiography and systolic time intervals (STI) for ventricular function assessment.
- Correlated findings with clinical status and hemodynamic data.
Main Results:
- Hemodynamics normalized in 18/20 patients; 2 had persistent pulmonary vascular disease.
- Right bundle branch block (RBBB) occurred in 11 patients; 5 with left axis deviation (LAD).
- Prolonged pre-ejection periods (PEP) and increased PEP/ET ratio indicated ventricular dysfunction, despite normal ejection times (ET) and echocardiographic parameters.
Conclusions:
- Postoperative ventricular dysfunction is common after VSD repair, evidenced by STI changes.
- Conduction defects (RBBB, LAD) and altered ventricular compliance are potential contributing factors.
- Abnormal septal motion (ASM) was frequent, possibly related to surgical factors.