Diagnosis and Management of Ventricular Septal Defects
This review addresses the diagnosis and management of ventricular septal defects (VSDs). The VSDs are classified on the basis of their size, their number, and their location in the ventricular septum. Natural history of VSDs includes spontaneous closure, development of pulmonary hypertension, onset...
| Autor principal: | |
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| Formato: | Artigo |
| Idioma: | English |
| Publicado em: |
IMR Press
2024-11-01
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| coleção: | Reviews in Cardiovascular Medicine |
| Assuntos: | |
| Acesso em linha: | https://www.imrpress.com/journal/RCM/25/11/10.31083/j.rcm2511411 |
| _version_ | 1826956676449697792 |
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| author | P. Syamasundar Rao |
| author_facet | P. Syamasundar Rao |
| author_sort | P. Syamasundar Rao |
| collection | DOAJ |
| description | This review addresses the diagnosis and management of ventricular septal defects (VSDs). The VSDs are classified on the basis of their size, their number, and their location in the ventricular septum. Natural history of VSDs includes spontaneous closure, development of pulmonary hypertension, onset of infundibular obstruction, and progression to aortic insufficiency. While initial diagnostic approaches such as careful history-taking, physical examination, chest X-rays, and electrocardiograms provide basic information, echo-Doppler studies are essential for assessing the defect's clinical significance and determining the need for intervention. Intervention is usually indicated for symptomatic patients with moderate- to large-sized VSDs. Surgical closure is advised for perimembranous, supracristal and inlet VSDs, and for deficits involving prolapsed aortic valve leaflets. While percutaneous methods to occlude perimembranous VSDs with Amplatzer Membranous VSD Occluder are feasible, they are not recommended due to a notable risk of inducing complete heart block in a significant number of patients. Alternatively, percutaneous and hybrid methods employing the Amplatzer Muscular VSD Occluder are effective for treating large muscular VSDs. The majority of treatment options have demonstrated satisfactory outcomes. However, practitioners are urged to exercise caution in managing small defects to avoid unnecessary procedures and to ensure timely intervention for large VSDs to prevent pulmonary vascular obstructive disease. |
| first_indexed | 2025-02-18T00:10:08Z |
| format | Article |
| id | doaj.art-18e72ab3be9f49f9a31ea4e05a27055c |
| institution | Directory Open Access Journal |
| issn | 1530-6550 |
| language | English |
| last_indexed | 2025-02-18T00:10:08Z |
| publishDate | 2024-11-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-18e72ab3be9f49f9a31ea4e05a27055c2024-11-30T06:29:19ZengIMR PressReviews in Cardiovascular Medicine1530-65502024-11-01251141110.31083/j.rcm2511411S1530-6550(24)01541-2Diagnosis and Management of Ventricular Septal DefectsP. Syamasundar Rao0Children’s Heart Institute, UT Health McGovern Medical School, Houston, TX 77030, USAThis review addresses the diagnosis and management of ventricular septal defects (VSDs). The VSDs are classified on the basis of their size, their number, and their location in the ventricular septum. Natural history of VSDs includes spontaneous closure, development of pulmonary hypertension, onset of infundibular obstruction, and progression to aortic insufficiency. While initial diagnostic approaches such as careful history-taking, physical examination, chest X-rays, and electrocardiograms provide basic information, echo-Doppler studies are essential for assessing the defect's clinical significance and determining the need for intervention. Intervention is usually indicated for symptomatic patients with moderate- to large-sized VSDs. Surgical closure is advised for perimembranous, supracristal and inlet VSDs, and for deficits involving prolapsed aortic valve leaflets. While percutaneous methods to occlude perimembranous VSDs with Amplatzer Membranous VSD Occluder are feasible, they are not recommended due to a notable risk of inducing complete heart block in a significant number of patients. Alternatively, percutaneous and hybrid methods employing the Amplatzer Muscular VSD Occluder are effective for treating large muscular VSDs. The majority of treatment options have demonstrated satisfactory outcomes. However, practitioners are urged to exercise caution in managing small defects to avoid unnecessary procedures and to ensure timely intervention for large VSDs to prevent pulmonary vascular obstructive disease.https://www.imrpress.com/journal/RCM/25/11/10.31083/j.rcm2511411ventricular septal defectsechocardiographysurgical closuretranscatheter occlusion |
| spellingShingle | P. Syamasundar Rao Diagnosis and Management of Ventricular Septal Defects Reviews in Cardiovascular Medicine ventricular septal defects echocardiography surgical closure transcatheter occlusion |
| title | Diagnosis and Management of Ventricular Septal Defects |
| title_full | Diagnosis and Management of Ventricular Septal Defects |
| title_fullStr | Diagnosis and Management of Ventricular Septal Defects |
| title_full_unstemmed | Diagnosis and Management of Ventricular Septal Defects |
| title_short | Diagnosis and Management of Ventricular Septal Defects |
| title_sort | diagnosis and management of ventricular septal defects |
| topic | ventricular septal defects echocardiography surgical closure transcatheter occlusion |
| url | https://www.imrpress.com/journal/RCM/25/11/10.31083/j.rcm2511411 |
| work_keys_str_mv | AT psyamasundarrao diagnosisandmanagementofventricularseptaldefects |