Ventricular septal defect and associated complications

J Pak Med Assoc. 2011 Oct;61(10):1001-4.


Objective: To determine the frequency of various types of ventricular septal defects (VSD) and associated complications in local paediatric population.

Methods: A cross sectional descriptive study was conducted on children undergoing echocardiography in a single centre from January 2006 to December 2009 at Paediatric Cardiology Department, Ch. Pervaiz Elahi Institute of Cardiology Multan- Tertiary referral centre for paediatric and adult cardiac services in South Punjab. The data on all children below 15 years of age undergoing detailed transthoracic two-dimensional echo and Doppler studies was reviewed. Cases with isolated ventricular septal defects were studied for age of presentation, gender, type, and associated complications. The data was analyzed with SPSS 11 version.

Results: A total of 5018 patients with congenital heart diseases underwent echocardiography during this period. A total of 1276 patients had isolated VSD (25%). Mean age was 3.1 +/- 3.64 years (range: 1 day to 15 years). Females were 440 (34.5%) and males were 836 (66.5%). Of 1276 patients, 1014 (79.3%) were Perimembranous type, 124 (9.8%) were muscular type, 85 (6.7%) were doubly committed subarterial type and 53 (4.2%) inlet VSD. Small, moderate and large VSDs were 428 (33.6%), 443 (34.7%) and 405 (31.7%) respectively. Severe pulmonary hypertension was noted in 286 (22.4%) cases. Aortic valve prolapse was present in 85 (6.7%) cases and varying degrees of aortic valve regurgitation was seen in 67 (5.2 %) patients. Right ventricular outflow tract obstruction was found in 21 (1.6%) cases. Left ventricular outflow tract obstruction was noted in 09 (0.7%) cases. Echo evidence of infective endocarditis was present in 06 (0.5%) patients.

Conclusion: Perimembranous ventricular septal defect was found to be the commonest type of ventricular septal defect. Large ventricular septal defects usually lead to severe pulmonary hypertension. Severe pulmonary hypertension was the commonest complication followed by Aortic Valve Prolapse and Aortic Regurgitation. Rest of the complications were rare.

MeSH terms

  • Adolescent
  • Aortic Valve Insufficiency / etiology*
  • Aortic Valve Prolapse / etiology*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Echocardiography
  • Female
  • Heart Septal Defects, Ventricular / complications*
  • Heart Septal Defects, Ventricular / diagnostic imaging
  • Humans
  • Hypertension, Pulmonary / etiology*
  • Infant
  • Infant, Newborn
  • Male
  • Severity of Illness Index