SPECTRUM OF VENTRICULAR SEPTAL DEFECTS IN PATIENTS WITH CONGENITAL HEART DISEASE

Abstract

Objective: To study the frequency and spectrum (echocardiographic picture) of
congenital venticular septal defect (VSD) among patients attending Paediatric
Cardiology Department for suspected congenital heart disease (CHD).
Methodology: This descriptive study was conducted in Pediatric Cardiology
Department Lady Reading Hospital Peshawar, from 01 September 2012 to 31
August 2013. All patient with suspected CHD was subjected to transthoracic
echocardiographic examination. The frequency and spectrum of VSD was
determine in these patients.
Results: A total of 2342 patients with suspected CHD were studied. Among them
708(30.2%) were having isolated congenital VSD. Males were 433(61%) and
females were 275(39%). Mean age was 42.32±40.64 months (range: 1 day to
30 years). Patients below 2 years were 54%. Out of this 708 patients,
447(63.1%) were of perimembranous type,169(23.86%) were having muscular
VSD, 48(6.78%) were Doubly committed subarterial type, and 44(6.21%) were
having multiple VSDs. Two hundred and thirty-three (32.9%) of total VSD patients
were have already developed complications including severe pulmonary artery
hypertension(PAH) in 157(22.17%) patients, aortic cusp prolapse in 50(7.06%)
cases including 30(6.86%) with perimembranous and 20(41.6%) with doubly
committed subarterial type of VSD, AR in 40(5.64%) of Aortic cusp prolapse,
Acquired right and left ventricular outflow tract obstruction in 10(1.4%) and
05(0.70%) respectively, 04(0.56%) patients had Echo evidence of infective
endocarditis and 2 had already developed Eisenmenger syndrome with severe
PAH.
Conclusion: VSD account for about 30% of the congenital cardiac defects. About
one third of them had already developed complications at the time of diagnosis.