Echocardiographic Evaluation of Anatomical Abnormalities of Interventricular Septum (with Special Reference to Ventricular Septal Defect) in the Population of West Bengal between 1 and 12 Years of Age

Abstract

BACKGROUNDRight and left ventricles of human heart are separated by interventricular septum. The septum develops in early embryonic period from three sources: primitive ventricular septum, bulbar septum and endocardial cushion. Primitive ventricular septum forms the major part of muscular septum, some contribution comes from bulbar septum. Endocardial cushion forms the membranous part of ventricular septum. Obviously, these three parts fuse to form a complete septum. Sometimes they do not fuse properly, or one of them does not proliferate properly, leading to formation of a defective septum containing one or more foramina. This condition is called ventricular septal defect. Commonly, endocardial cushion does not proliferate properly producing defect in membranous septum. Less commonly foramina are situated in muscular septum. Perimembranous VSD is described as foramen lies in membranous septum and surrounding it, which is due to non-proliferation of endocardial cushion as stated above, and also due to non-fusion of two bulbar septi. So VSDs may be perimembranous or muscular. In the University of Padua, Itali, Dr. Gaetono Thiene dissected several cadaveric heart specimens and found many cases of VSDs. Among them, perimembranous VSD was the most common (90%); some were muscular (10%) and some were having more than one orifice (10%). In our study, we try to find out the types of VSDs by echocardiography in living subjects and then compare it with the data of Dr. Gaetono Thiene. METHODSBy simple random sampling method, two hundred patients of age group 1-12 years having clinical features of VSD were chosen in the Cardiology OPD, Nilratan Sircar Medical College, Kolkata, West Bengal, India. By echocardiography, VSD was confirmed along with its type. The findings were tabulated, and the data was statistically analysed. RESULTSWe got 83% perimembranous VSD, 15.5% muscular VSD and 1.5% having more than one orifice in the ventricular septum. CONCLUSIONSPerimembranous VSD is so far the most common, next is the muscular VSD.