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» Ventricular septal defect - Diagnosis, Treatment
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Ventricular septal defect - Diagnosis, Treatment
Ventricular septal defect - Diagnosis, Treatment
This heart defect detected in 10-30% of children with congenital heart disease. This is one of the most common defects. For every thousand births born two children with ventricular septal defect. Interventricular septum, respectively, shares the name of the left and right ventricles of the heart. Normally, the holes in it does not happen.
Ventricular septal defect - is the presence of holes in the barrier through which the blood from the left ventricle may fall into the right and vice versa. Because the left ventricle is more powerful right, initially cleared the blood from the left ventricle to the right, from the systemic circulation in the small. When an overload of pulmonary circulation is pulmonary vasospasm, they sclerotherapy, compressed, the pressure increases in a small circle and when it exceeds the pressure in the systemic circulation, develops the reverse process - the blood is cleared from the right ventricle to the left. The patient appears cyanosis (blue nasolabial triangle, the nail plate).
Quite often possible spontaneous closure of ventricular septal defect. In the first month of life rose about 80% of the holes, but perhaps self-closing and opening at a later date. Closure is mainly due to the muscular layer of interventricular septum.
Ventricular septal defects are divided by location. Under the aorta, in the middle layer and lower - the muscle that often spontaneously close.
The size:
larger defects are holes with a diameter equal to or greater than the diameter of the aorta, the pressure of such defects in both parts of the heart is almost the same
Medium when the hole size is smaller than the pressure in the aorta and right ventricle is 50% of left ventricular pressure
small, the volume of blood in the pulmonary circulation increases by 25%. Usually children are well developed physically. No complaints. In the heart of the chest may bulge. A so-called "heart bump."
Diagnosis.
When the feeling of her chest revealed tremor during systole (contraction of the heart). When listening to is determined by a rough systolic murmur. An electrocardiogram may be normal. The primary method for diagnosing echocardiography. Echocardiography revealed blood flow between the ventricles. In doubtful cases, the sensing is carried out of the cavities of the heart.
Treatment.
If your child has a large ventricular septal defect, and there are signs of heart failure, surgery is performed in the first three months of life. At six months the need for surgery is determined by the pressure in the pulmonary circulation (pulmonary arteries). If it is low and the child's condition is good, delaying surgery until 12 months, as during this time the defect may close itself. In some children, surgery may be delayed up to 5 years. Under the conditions of extracorporeal circulation is closure of the hole or plastic patch. Usually surgery is performed through the right atrium is the most gentle method. When the impossibility of this approach through the left atrium, aorta and pulmonary artery.
Mortality in the surgical treatment does not exceed 3%. In 2-7% of cases for various reasons, there is a need for reoperation. Long-term results are good for more than 80% of operated patients. After 2-3 years, children can lead a normal life.
