File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Analysis of indications for surgical closure of subarterial ventricular septal defect without associated aortic cusp prolapse and aortic regurgitation

TitleAnalysis of indications for surgical closure of subarterial ventricular septal defect without associated aortic cusp prolapse and aortic regurgitation
Authors
Issue Date2001
PublisherExcerpta Medica, Inc.. The Journal's web site is located at http://www.ajconline.org/
Citation
American Journal Of Cardiology, 2001, v. 87 n. 11, p. 1266-1270 How to Cite?
AbstractSubarterial ventricular septal defect (VSD) is relatively common in Orientals. We reviewed the outcome of 214 patients (137 males) who were followed for 8.6 ± 5.2 years (range 0.1 to 24.3) and addressed the issue regarding the necessity and optimum timing of closing subarterial defects before development of aortic valve deformities. Demographic data, transthoracic and transesophageal echocardiographic findings, cardiac catheterization results, and operative findings were reviewed. Kaplan-Meier actuarial analysis was performed to assess the development of aortic valve complications over time. Seventy-five patients with heart failure and pulmonary hypertension underwent surgical closure of VSD at the age of 2.4 ± 2.9 years. No patient had aortic cusp prolapse before operation and none developed aortic cusp prolapse or aortic regurgitation (AR) on follow-up. In contrast, of the 139 asymptomatic patients managed conservatively, 102 (73%) developed aortic cusp prolapse, 78% of whom (80 of 102) developed AR. The prevalence of aortic cusp prolapse and AR at 1, 5, 10, and 15 years old was 8%, 30%, 64%, and 83%, and 3%, 24%, 45%, and 64%, respectively. Significant prolapse or AR prompted surgical closure of VSD with (n = 22) or without (n = 26) valvoplasty in 48 of 102 patients (47%). The size of the VSD was significantly larger in patients with heart failure (9.6 ± 3.3 mm) or aortic cusp prolapse (11.7 ± 4.1 mm) compared with those without heart failure (4.5 ± 1.4 mm, p <0.001). All patients with aortic cusp prolapse and all but 1 with heart failure had a defect size of ≥5 mm. In conclusion, subarterial VSD of ≥5 mm should be closed as early as possible to prevent development of aortic cusp prolapse and AR. Asymptomatic patients with small defects <5 mm could be managed conservatively. © 2001 Excerpta Medica, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/170312
ISSN
2014 Impact Factor: 3.276
2013 SCImago Journal Rankings: 2.315
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLun, KSen_US
dc.contributor.authorLi, Hen_US
dc.contributor.authorLeung, MPen_US
dc.contributor.authorChau, AKTen_US
dc.contributor.authorYung, TCen_US
dc.contributor.authorChiu, CSWen_US
dc.contributor.authorCheung, YFen_US
dc.date.accessioned2012-10-30T06:07:25Z-
dc.date.available2012-10-30T06:07:25Z-
dc.date.issued2001en_US
dc.identifier.citationAmerican Journal Of Cardiology, 2001, v. 87 n. 11, p. 1266-1270en_US
dc.identifier.issn0002-9149en_US
dc.identifier.urihttp://hdl.handle.net/10722/170312-
dc.description.abstractSubarterial ventricular septal defect (VSD) is relatively common in Orientals. We reviewed the outcome of 214 patients (137 males) who were followed for 8.6 ± 5.2 years (range 0.1 to 24.3) and addressed the issue regarding the necessity and optimum timing of closing subarterial defects before development of aortic valve deformities. Demographic data, transthoracic and transesophageal echocardiographic findings, cardiac catheterization results, and operative findings were reviewed. Kaplan-Meier actuarial analysis was performed to assess the development of aortic valve complications over time. Seventy-five patients with heart failure and pulmonary hypertension underwent surgical closure of VSD at the age of 2.4 ± 2.9 years. No patient had aortic cusp prolapse before operation and none developed aortic cusp prolapse or aortic regurgitation (AR) on follow-up. In contrast, of the 139 asymptomatic patients managed conservatively, 102 (73%) developed aortic cusp prolapse, 78% of whom (80 of 102) developed AR. The prevalence of aortic cusp prolapse and AR at 1, 5, 10, and 15 years old was 8%, 30%, 64%, and 83%, and 3%, 24%, 45%, and 64%, respectively. Significant prolapse or AR prompted surgical closure of VSD with (n = 22) or without (n = 26) valvoplasty in 48 of 102 patients (47%). The size of the VSD was significantly larger in patients with heart failure (9.6 ± 3.3 mm) or aortic cusp prolapse (11.7 ± 4.1 mm) compared with those without heart failure (4.5 ± 1.4 mm, p <0.001). All patients with aortic cusp prolapse and all but 1 with heart failure had a defect size of ≥5 mm. In conclusion, subarterial VSD of ≥5 mm should be closed as early as possible to prevent development of aortic cusp prolapse and AR. Asymptomatic patients with small defects <5 mm could be managed conservatively. © 2001 Excerpta Medica, Inc.en_US
dc.languageengen_US
dc.publisherExcerpta Medica, Inc.. The Journal's web site is located at http://www.ajconline.org/en_US
dc.relation.ispartofAmerican Journal of Cardiologyen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAortic Valve Insufficiency - Surgery - Ultrasonographyen_US
dc.subject.meshAortic Valve Prolapse - Surgery - Ultrasonographyen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshEchocardiographyen_US
dc.subject.meshEchocardiography, Transesophagealen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHeart Catheterizationen_US
dc.subject.meshHeart Defects, Congenital - Surgery - Ultrasonographyen_US
dc.subject.meshHeart Septal Defects, Ventricular - Surgery - Ultrasonographyen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshInfant, Newbornen_US
dc.subject.meshMaleen_US
dc.subject.meshPostoperative Complications - Ultrasonographyen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleAnalysis of indications for surgical closure of subarterial ventricular septal defect without associated aortic cusp prolapse and aortic regurgitationen_US
dc.typeArticleen_US
dc.identifier.emailCheung, YF:xfcheung@hku.hken_US
dc.identifier.authorityCheung, YF=rp00382en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/S0002-9149(01)01517-Xen_US
dc.identifier.pmid11377352en_US
dc.identifier.scopuseid_2-s2.0-0035371337en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035371337&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume87en_US
dc.identifier.issue11en_US
dc.identifier.spage1266en_US
dc.identifier.epage1270en_US
dc.identifier.isiWOS:000169027700007-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLun, KS=8363663600en_US
dc.identifier.scopusauthoridLi, H=8701136400en_US
dc.identifier.scopusauthoridLeung, MP=7201944800en_US
dc.identifier.scopusauthoridChau, AKT=35787094400en_US
dc.identifier.scopusauthoridYung, TC=9132842300en_US
dc.identifier.scopusauthoridChiu, CSW=8714554800en_US
dc.identifier.scopusauthoridCheung, YF=7202111067en_US

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats