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A Clinical Observation on Isolated Ventricular Septal Defect In Children.

Journal of the Korean Pediatric Society 1984;27(7):702-710.
Published online July 31, 1984.
A Clinical Observation on Isolated Ventricular Septal Defect In Children.
Chang Ho Lee, Kwang Do Lee, Sang Bum Lee, Ja Hoon Koo
Department of Pediatrics, School of Medicine, Kyungpook National Universityy Taegu, Korea
소아의 단순 심실중격결손증
이창호, 이광도, 이상범, 구자훈
경북대학교 의과대학 소아과학교실
Abstract
A clinical study was done an 39 cases of isolated VSD who had been admitted to the Pediatric Department of Kyungpook National University Hospital, and and confirmed by cardiac catheterization during the period from January 1975 to May 1983. The results were as follows; Out of 77 cases of congenital heart disease underwent cardiac catheterization, 39 cases were isolated VSD, comprising 50.6%. An even age distribution was noted between 1 and 15 years of age, and male to female ratio was 1.3 : 1. Case distribution by hemodynamic data was as follows; Group A (Qp/Qs1.8 Pp/Ps<0.45); 4, Group (Qp/Qs>1.8, Pp/Ps>0.45); 6,and Group D(Qp/Qs<1.8, Pp/Ps>0.45) ; 7. The common presenting symptoms were dyspnea on exertion in 76.9%, frequent upper respiratory infection in 61.5%, easy fatigability in 46.2%, palpitation in 41.0%, and growth retardation in 41.0%. Physical findings showed cardiac murmur in 100.0%, thrill in 82.0%, hepatomegaly in 48.7%, and chest deformity in 35.9%. On chest radiogram, pulmonary vascular marking was increased in all but one cases, and cardiomegaly was seen in 82.1%, which were more marked in Group C and D, and in you nger age. Electrocardiographic findings showed LVH in 26.3%, RVH in 10.5%, BVH in 31.6%, and no ventricular hypertrophy in 31.6%. Systolic pulmonary artery pressure and Pp/Ps were higher in cases with RVH and BVH, and Qp/Qs was higher in cases with LVH than in no ventricular hypertrophy. Of 14 operated cases, size of defect was largest in Group C, and according to the Kirklin's classification, 5 cases belonged to type I, and 9 cases type I. Two death occurred postoperatively in the Group of C and D, giving overall survival rate of 85.7%.
Key Words: Isolated ventricular septal defect, Cardiac catheterization, Heart failure


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