| Clinical Study of Subarterial Ventricular Septal Defect |
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Yon Sook Rho1, Yong Won Park1, Sang Woo Kim1, Bon Il Ku2, Sang Joon Oh2, Hong Sup Lee2, Chang Ho Kim2 |
1Department of Pediatrics, Inje University, Seoul Paik Hospital, Seoul, Korea
2Department of Thoracic & Cardiovascular Surgery, Inje University, Seoul Paik Hospital, Seoul, Korea |
| 대혈관판하 심실중격결손증에 관한 임상적 고찰 |
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노연숙1, 박용원1, 김상우1, 구본일2, 오상준2, 이홍섭2, 김창호2 |
1인제대학교 의과대학 서울백병원 소아과학교실
2인제대학교 의과대학 서울백병원 흉부외과학교실 |
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| Abstract |
Purpose
: The incidence of subarterial ventricular septal defect(SA VSD) ranges 25-30% among oriental patients with VSDs, which is greater than 5% reported in western. Natural history of the disease is characterized by progressive aortic valve prolapse(AVP), frequently subarterial VSD, we evaluated clinical characteristics emphasizing on the incidence of AVP and the degree of AI as aging.
Methods
: Study subjects consisted of 140 patients, who were diagnosed as subarterial VSD and operated in Seoul paik Hospital during a 5 year period from Jan.1988 to Dec. 1992. The data were analyzed detrospectively as to clinical profiles, data of cardiac catheterization, frequencies of AVP, and AI in 5 each age group, operative methods, postoperative complications and mortality.
Results
: The incidence of subarteial VSD was 34.6% of total operated VSD cases. Data of preoperative cardiac catheterization showed mean values of Qp/Qs and systolic pulmonary artery pressure, 1.43¡¾0.47 and 33.8¡¿16.4mmHg in each. Aortic valve prolapses and aortic insufficiencies were observed in 70.0% and 20.7% among patients, which showed increasing tendencies as ages increased. As operative methods, patch closures through main pulmonary artery were done mainly. In mild cases without AI or with grade I AI, simple VSD closures were performed but in more a advanced cases, 10 aortic valvuloplasties and additional 2 aortic valve replacements were performed. Total mortality rate was 2.1%.
Conclusion
: In the management of subarterial VSD, early elective closure regardless of shunt volume is important to prevent progressive aortic valve prolapse leading to aortic insufficiency. |
| Key Words:
Subarterial VSD, Aortic Valve Prolapse, Aortic Insufficiency |
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