All issues > Volume 28(9); 1985

Original Article

J Korean Pediatr Soc. 1985;28(9):869-879. Published online September 30, 1985.

So-called 'Septal Aneurysm' in membranous Ventricular Septal defect.

Han Young Lee, In Hee Park, Ha Baik Lee, Heung Jae Lee

¹Department of Pediatrics, College of Medicine,Hanyang University, Seoul, Korea

Abstract

During the period of 4 years from October, 1980 to September, 1984, 28 cases with septal aneurysm in membranous ventricular septal defect were observed and evaluated at Hanyaeng University Hospital, and those were confirmed by LV angiogram and/or 2D-echocardiogram. We also correlated the findings of aneurysm of the membranous septum with clinical, electrocardiographic and hemodynamic data for use in noninvasive studies. The summary of this article is made as follows: 1)The proportion of female sex in this series was 61%, and mean age was 6.4 years with the range from 8 month old to 24 years old. 2)Among the 15 cases who underwent cardiac catheterization, 10 cases revealed a relatively small left-to-right shunt with Qp/Qs less than 1.5, and normal pulmonary resistance. The chest X-rays were normal or nearly normal in heart size, shape and pulmonary vascularity. 3)Among the 15 cases who underwent cardiac catheterization, 5 cases revealed a moderate to large pulmonary flow with Qp/Qs more than 1.5 and 3 of them showed Qp/Qs more than 2,0. They had the clinical evidence of congestive heart failure during infancy, precordial bulging on physical examination, and moderate cardiac enlargement with pulmonary plethora on chest X-ray. 4)The detection rate of LV angiocardiogram for so-called ‘septal aneurysm* was 86.7%. Meanwhile that of non-invasive 2-0 echocardiography was 81.5%, which could be used as a useful diagnostic and follow up method. 5)The formation of an aneurysm of the membranous septum appears to be main mechanism of spontaneous closure of a ventricular septal defect because of the presence of septal aneurysm in 8 cases with spontaneous closure of a VSD.

Keywords :Septal aneurysm;Membranous ventricular septal defect; Spontaneous closure; Echocardiogram