Correlation of anatomic and hemodynamic features with aortic valve leaflet deformity in doubly committed subarterial ventricular septal defect

Kobayashi, Jun; Koike, Kazuhiko; Senzaki, Hideaki; Kobayashi, Toshiki; Tsunemoto, M; Ishizawa, Atsushi; Ohta, Yoshihiro; Shimada, Muneaki; Omoto, Ryozo

doi:10.1007/bf01747853

Cited by 14 publications

(13 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All control patients had a subpulmonic ventricular septal defect, which can potentially cause aortic valve prolapse with resultant aortic regurgitation. 18 All patients with ventricular septal defect had undergone cardiac catheterization previously to check for deformities of the aortic valves and their relations to ventricular septal defect. 18 This was based on the management protocol adopted by our institution for all such patients before 2000.…”

Section: Patientsmentioning

confidence: 99%

“…18 All patients with ventricular septal defect had undergone cardiac catheterization previously to check for deformities of the aortic valves and their relations to ventricular septal defect. 18 This was based on the management protocol adopted by our institution for all such patients before 2000. All medications for patients with COA were withheld 24 hours before the study, and the same anesthesia protocol was used in all study subjects (premedication with intramuscular pethidine combined with atropine and sedation with continuous infusion of sodium thiamylal during catheterization).…”

Section: Patientsmentioning

confidence: 99%

See 1 more Smart Citation

Ventricular–Vascular Stiffening in Patients With Repaired Coarctation of Aorta

Senzaki¹,

Iwamoto²,

Ishido³

et al. 2008

Circulation

Self Cite

View full text Add to dashboard Cite

Background-Despite successful repair, patients with coarctation of the aorta (COA) often show persistent hypertension at rest and/or during exercise. Previous studies indicated that the hypertension is mainly due to abnormalities in the arterial bed and its regulatory systems. We hypothesized that ventricular systolic stiffness also contributes to the hypertensive state in these patients in addition to increased vascular stiffness. Methods and Results-The study involved 43 patients with successfully repaired COA and 45 age-matched control subjects. Ventricular systolic stiffness (end systolic elastance) and arterial stiffness (effective arterial elastance) were measured invasively by ventricular pressure-area relationship during varying preload before and after ␤-adrenergic stimulation. The mean systolic blood pressure was significantly higher with concomitant increases in both end systolic elastance and effective arterial elastance in patients with COA compared with control subjects (113.2Ϯ16.8 versus 91.0Ϯ9.1 mm Hg, 44.5Ϯ17.0 versus 19.2Ϯ6.7 mm Hg/mL/m 2 , and 27.8Ϯ11.4 versus 20.2Ϯ4.8 mm Hg/mL/m 2 , respectively; PϽ0.01 for each). End systolic elastance and effective arterial elastance of patients with COA showed exaggerated responses to ␤-adrenergic stimulation, further amplifying blood pressure elevation. Quantification analyses assuming that ventricular systolic stiffness of patients with COA is equal to that of the control revealed that ventricular systolic stiffness accounts for approximately 50% to 70% of the elevated blood pressure in patients with COA. Furthermore, combined ventricular-arterial stiffening amplified systolic pressure sensitivity to increased preload during abdominal compression and limited stroke volume gain/relaxation improvement induced by ␤-adrenergic stimulation. Conclusions-Increased ventricular systolic stiffness, coupled with increased arterial stiffness, plays important roles in hypertension in patients with repaired COA. Thus, ventricular systolic stiffness is a potentially suitable target for reduction of blood pressure and improvement of prognosis of patients with COA. (Circulation. 2008;118[suppl 1]:S191-S198.)

show abstract

Section: Patientsmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

Ventricular–Vascular Stiffening in Patients With Repaired Coarctation of Aorta

Senzaki¹,

Iwamoto²,

Ishido³

et al. 2008

Circulation

Self Cite

View full text Add to dashboard Cite

show abstract

“…10 Patients with obvious prolapse of an aortic cusp into the VSD have the highest risk of developing progressive aortic regurgitation. We found 2.3% of our patients developed aortic regurgitation which was more common in case of perimembranous type of VSD.…”

Section: Discussionmentioning

confidence: 99%

“…9 Aortic regurgitation is progressive in nature and presence of even mild aortic regurgitation or aortic valve prolapse in the absence of aortic regurgitation is an indication for surgery. 10 Perimembranous outlet VSD are also associated with infundibular hypertrophy, and right ventricular outflow tract obstruction can progress in severity. This also requires surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

Small Ventricular Septal Defect Considered Not Requiring Surgical Closure: The Frequency of Developing Complications in Our Center

Hyder¹,

Kazmi²,

Kazmi³

2016

Heart Res Open J

View full text Add to dashboard Cite

Objectives:The study was conducted to check the frequency of development of complication in the patients with small Ventricular Septal Defects (VSDs) considered not requiring surgical closure during childhood. Methods: A descriptive study was conducted on children from January 2015 to December 2015 at Children Hospital and Institute of Child Health, Lahore, Pakistan. The data with isolated VSDs considered too small to require surgery from 1 month to 15 years of age were reviewed. The data was analyzed with SPSS 20 version. Results: The total of 883 patients of restrictive VSDs considered not to require surgery, 60.6% (n=535) were males and 39.4% (n=348) were females. The significant number of patients i.e. 18.7% (n=166) developed complications. Aortic cusp prolapsed developed in 13.6% i.e. p≤0.05, 2.3% developed aortic regurgitation secondary to aortic cusp prolapsed. 1.8% developed right ventricular track outflow obstruction (RVOT) i.e. p≤0.05 and 0.3% of patient developed left ventricular outflow track obstruction (LVOT) i.e. p≤0.05. Similarly 0.8% patients developed endocarditis. Regarding types of VSD, we found Perimembranous in 65.8%, muscular in 12.6%, Subaorticin 8.3%, doubly committed in 6.0%, Inlet in 5% and outlet in 1.7% of our patients. Conclusions: Patients with small restrictive Ventricular Septal Defects (VSDs) generally been considered as do not required surgery, the data suggested that a significant percentage of these patients developed complications later in their life i.e., 18.7%.

show abstract

“…In contrast, up to 33% of VSDs in the Asian population are dcVSDs [1]. A dcVSD is situated directly beneath the ventricular outlet with the adjacent leaflets of the pulmonary and aortic valves in fibrous continuity [2]. There are many synonymous names given to this type of VSD, such as supracristal, subarterial infundibular or subpulmonary, or subpulmonic VSD.…”

Section: Introductionmentioning

confidence: 99%

Doubly Committed Ventricular Septal Defect: Single-Centre Experience and Midterm Follow-Up

Gabriels

Gewillig²,

Meyns³

et al. 2011

Cardiology

View full text Add to dashboard Cite

Background: Doubly committed ventricular septal defect (dcVSD) is the least common type of VSD. Because published studies are rather scarce, this study aimed at evaluating the midterm outcome of dcVSDs. Methods: The records of all patients registered in the database of Paediatric and Congenital Cardiology, University Hospitals Leuven, with a dcVSD at 16 years of age were reviewed. Clinical, electrocardiographic and transthoracic echocardiographic changes from baseline, defined as of the age of 16 years, until the latest follow-up were compared. Results: Thirty-three patients (20 males, median age 26 years, interquartile range 12) were followed for a median time of 7.9 years (interquartile range 9.8, time range 2–25.9). No deaths occurred. In 15 patients (45%), the defect remained patent at baseline. During follow-up, two spontaneous closures (13%) occurred. Eighteen patients (55%) required closure before the age of 16 years. Five (28%) needed reoperation. In the dcVSD closure group, left ventricular ejection fraction decreased from 69 ± 12 to 61 ± 6% (p = 0.028). No significant changes in pulmonary arterial hypertension were noticed. Conclusions: Patients with persistently patent dcVSD remained nearly event free during follow-up. Event-free survival after dcVSD closure was markedly lower. These patients developed reduced left ventricular function and had a high risk of reintervention.

show abstract

Correlation of anatomic and hemodynamic features with aortic valve leaflet deformity in doubly committed subarterial ventricular septal defect

Cited by 14 publications

References 11 publications

Ventricular–Vascular Stiffening in Patients With Repaired Coarctation of Aorta

Ventricular–Vascular Stiffening in Patients With Repaired Coarctation of Aorta

Small Ventricular Septal Defect Considered Not Requiring Surgical Closure: The Frequency of Developing Complications in Our Center

Doubly Committed Ventricular Septal Defect: Single-Centre Experience and Midterm Follow-Up

Contact Info

Product

Resources

About