07-21-2009, 09:45 AM
peri - membranous are less likely to close. and if assoc with AR (though more common in supra cristal type) immediate surgery is advised..
muscular are more likely for spontaneous closure.. though size is main criteria..
small/moderate + asymptomatic - wait
Large defect or elevated PVR or symptomatic - surgery
the criteria for vsd closure, depends on symptoms, PVR and PAP..
QP/QS > 2:1 in children and >1.5:1 in adults is indiaction for surgery
also PVR should ideally be less than 60-70% of the sys. PVR >8 is contraindication for surgery..
also if CHF present, do closure irrespective of age (even less than 6 mon)
also if Infec. endocarditis is present, treat IE then after that close the defect however small the defect is
muscular are more likely for spontaneous closure.. though size is main criteria..
small/moderate + asymptomatic - wait
Large defect or elevated PVR or symptomatic - surgery
the criteria for vsd closure, depends on symptoms, PVR and PAP..
QP/QS > 2:1 in children and >1.5:1 in adults is indiaction for surgery
also PVR should ideally be less than 60-70% of the sys. PVR >8 is contraindication for surgery..
also if CHF present, do closure irrespective of age (even less than 6 mon)
also if Infec. endocarditis is present, treat IE then after that close the defect however small the defect is