VENTRICULAR SEPTAL DEFECTS

 

Ventricular septal defects are the most common congenital cardiac defect, accounting for 30% of heart defects in live born infants

and 9.7% in fetuses (1,2). VSD's are associated with other cardiac malformations in about 50% of cases (3). VSD's have the

highest recurrence rate and is the most  teratogen-associated defect. 

 

 

ULTRASOUND

 

Link to Ultrasound

 

CLASSIFICATION

 

 

1. Membranous Defects (also called perimembranous or infracristal).

Perimembranous defect (80%)

Involve the membranous septum below the aortic valve with extension to a variable degree into the adjacent portion of the septum.

2. Muscular Defects (20%) - There are four subgroups classified by the location of the defect.

Inlet defect (5%)

Involve the inflow tract of the right ventricle and affects the implantation of the septal chordae of the tricuspid valve They are posterior and inferior to membranous defects.

Trabecular defects (5-20%)

Occur posterior to the septal band of the crista (trabecula septomarginalis) in the midportion of the septum Often multiple, small and tortuous.

Outlet defects (Conal, supracristal,subaortic or infundibular) (5%)

Occur anterior to the septal band of the RV in the most superior portion of the interventricular septum.

Apical defects (rare)

Occur at the apex of the heart distal to the insertion of the moderator band. They may be large and difficult to identify.

 

OTHER

 

Questions That Must be Answered When a VSD is Discovered?

Table of Types of Isolated Defects Versus Outcome at our Instititution
 

 

 

REFERENCES
  1. Hoffman JIE, Christianson R. Congenital heart disease in a cohort of 19,502 births with long term follow-up. Am J Cardiol 1978;42:641-647.
  2. Ferencz C, Rubin JD, McCarter RJ et.al. Cardiac and non-cardiac malformations: observations in a population based study. Tetralogy 1987;35:367-378.
  3. Goor DA, Lillehei CW. Congenital malformations of the heart. New York: Grune and Stratton 1975.