07-21-2009, 07:14 AM
What determines when VSD should be repaired?
What is the criteria for VSD... - oncogene
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07-21-2009, 07:14 AM
What determines when VSD should be repaired?
07-21-2009, 07:16 AM
1. symptomatic less then 2 yr old
2. not closed spontaneously after 2 yr, in asymptomatic
07-21-2009, 08:42 AM
correct
07-21-2009, 08:43 AM
also depends on muscular or membranous
07-21-2009, 09:11 AM
unstableangina
please explain. Thanks for your input
07-21-2009, 09:44 AM
small muscular VSD closes spontaneously - no treatment needed. Membranous- needs treatment if not closing/large shunts/symptomatic
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 |
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