A ventricular septal defect with a giant appendiform aneurysm of the membranous septum

Cozijnsen, Martinus A.; Cozijnsen, Luc; Maas, Arthur; Boo, M. Bakker-de; Bouma, Berto J.

doi:10.1007/s12471-012-0343-1

Cited by 5 publications

(9 citation statements)

References 8 publications

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“…Th ey described several events in sequence: left-to-right shunt fl ow jet toward the tricuspid valve, followed by deposition of fi brin over the margins of the defect and adhesion of the septal leafl et of the tricuspid valve to the margin of the VSD (24). Recently, Cozijnsen et al presented echocardiography showing a small isolated VSD (with a diameter of 6 mm) in association with a giant AMS (25 mm in length with a diameter of 8 mm), suggesting that the AMS closed the VSD (25). Perimembranous VSD.…”

Section: Mechanisms Responsible For Spontaneous Vsd Closurementioning

confidence: 99%

A Review of Spontaneous Closure of Ventricular Septal Defect

Zhang¹,

Ko²,

Guileyardo³

et al. 2015

Baylor University Medical Center Proceedings

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516Ventricular septal defect (VSD) is the most common congenital heart malformation and can be detected during the prenatal and postnatal period, in childhood, and in adulthood. Spontaneous closure of VSD can be determined through a variety of methods-echocardiography, Doppler color flow imaging, angiography, auscultation, and cardiac catheterization-and can be proven by pathological evidence at necropsy. There are two major types of VSD, membranous and muscular, as well as the perimembranous variety, which comprises variable portions of the adjacent muscular septum but lacks the membranous septum. VSD appears either as an isolated cardiac defect without other abnormalities or with several complex malformations. It has long been recognized that VSD can close spontaneously, but the incidence of spontaneous VSD closure is still uncertain. Since necropsy study of the hearts with VSD has rarely been reported, information on morphological features of spontaneous VSD closure remains limited. In addition, the mechanisms for spontaneous VSD closure are not fully understood. Herein, we present a brief review of the incidence of spontaneous VSD closure, morphological characteristics of the closure, and the main mechanisms responsible for the closure. INCIDENCE OF SPONTANEOUS VSD CLOSURETh e incidence of spontaneous ventricular septal defect (VSD) closure varies greatly, depending on the age and gender of subjects at spontaneous closure, the size and site of the defect, the types of defect, as well as the population studied, methods employed, and length of follow-up period. Table 1 presents available data on the incidence of spontaneous VSD closure.Age and gender. Age has been found to have a significant infl uence on the incidence of spontaneous VSD closure, whereas gender seems less likely to aff ect the incidence. Although spontaneous VSD closure can occur at any agegestation, infancy, childhood, adolescence, and adulthood (1)-it occurs most commonly during the fi rst 6 months of life (2), during the fi rst year (3, 4), or soon after the fi rst year of life (5). Afterward, the occurrence of closure declines progressively and occurs less commonly after the age of 10 (5). It has been documented that the incidence of the close increases with age, from 24% at 18 months of age to 50% at 48 months and 75% at 120 months (6). However, in older children, at 3.5 years old, the incidence declines sharply to 44% and then rises to 66% at 7 years and 75% at 10.5 years (6). A similar trend has been found in other reports, which showed 57% (109/190) of cases closed before 3 years of age, 89% (169/190) closed before 8 years of age (7), and 4% to 10% closed after the age of 17 (8, 9). During adulthood, the incidence of spontaneous VSD closure remarkably declines. One study showed that of 188 adults with VSD, 19 patients' (10%) VSD closed spontaneously between the age of 17 and 45 years, and the incidence of closure was greater in the 17-to 24-year age group than the 25-to 34-year group, the 35-to 44-year group, and the ≥45-year group (8)...

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Section: Mechanisms Responsible For Spontaneous Vsd Closurementioning

confidence: 99%

A Review of Spontaneous Closure of Ventricular Septal Defect

Zhang¹,

Ko²,

Guileyardo³

et al. 2015

Baylor University Medical Center Proceedings

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“…The latter will give rise to the characteristic outpouching “windsock” appearance on echocardiography, resulting from aneurysmal distension during ventricular systole . The sizes of the aneurysm have varied from 8 × 25 mm in one report to as large as 5 × 7 cm in others (Figure ) …”

Section: Cardiac Imagingmentioning

confidence: 99%

“…Less commonly, a left ventricular‐to‐right atrial communication can occur with a “Gerbode defect,” increasing the risk of complications . The strategic localization of the aneurysm and the traction imposed by ventricular systole to the atrioventricular bundle and its branches helps explain the genesis of certain conduction defects . Life‐threatening complications are related to thrombus formation, endocarditis, and related systemic emboli, persistent cardiac arrhythmias, and acute right‐to‐left shunts secondary to aneurysmal rupture.…”

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confidence: 99%

“…It was as high as 20% in some reports. 11,13,14 Nevertheless, the number of incidentally detected cases in adults has increased, but the incidence of those without residual shunts remains unknown. 1,12 In the absence of an interventricular shunt or concomitant cardiac surgery, guidelines for surgical intervention or resection of isolated membranous ventricular septal aneurysms are not well established.…”

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confidence: 99%

“…19 The strategic localization of the aneurysm and the traction imposed by ventricular systole to the atrioventricular bundle and its branches helps explain the genesis of certain conduction defects. 9,13,14,20 Life-threatening complications are related to thrombus formation, endocarditis, and related systemic emboli, persistent cardiac arrhythmias, and acute right-to-left shunts secondary to aneurysmal rupture. Overall, even if asymptomatic, membranous ventricular septal aneurysms are not as benign as previously thought ( Figure 2).…”

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Isolated Aneurysms of the Membranous Ventricular Septum Without Residual Shunts: Systematic Review and Description of 3 Cases in Adults

et al. 2017

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A ventricular septal defect is the most common congenital cardiac abnormality encountered in infants and children. Many of them survive through adulthood before diagnosis. Two-thirds of the cases involve the membranous part of the septum. In the absence of an interventricular shunt or concomitant cardiac surgery, guidelines for surgical intervention or resection of isolated aneurysms of the membranous septum are not well established. In this report, we discuss a multi-imaging modality approach for the diagnosis and assessment of membranous ventricular septal aneurysms and review the experts' consensuses for follow-up and treatment strategies.

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Cardiovascular Magnetic Resonance Imaging for Structural and Valvular Heart Disease Interventions

Cavalcante¹,

Lalude²,

Schoenhagen³

et al. 2016

JACC: Cardiovascular Interventions

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The field of percutaneous interventions for the treatment of structural and valvular heart diseases has been expanding rapidly in the last 5 years. Noninvasive cardiac imaging has been a critical part of the planning, procedural guidance, and follow-up of these procedures. Although echocardiography and cardiovascular computed tomography are the most commonly used and studied imaging techniques in this field today, advances in cardiovascular magnetic resonance imaging continue to provide important contributions in the comprehensive assessment and management of these patients. In this comprehensive paper, we will review and demonstrate how cardiovascular magnetic resonance imaging can be used to assist in diagnosis, treatment planning, and follow-up of patients who are being considered for and/or who have undergone interventions for structural and valvular heart diseases.

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A ventricular septal defect with a giant appendiform aneurysm of the membranous septum

Cited by 5 publications

References 8 publications

A Review of Spontaneous Closure of Ventricular Septal Defect

A Review of Spontaneous Closure of Ventricular Septal Defect

Isolated Aneurysms of the Membranous Ventricular Septum Without Residual Shunts: Systematic Review and Description of 3 Cases in Adults

Cardiovascular Magnetic Resonance Imaging for Structural and Valvular Heart Disease Interventions

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