Impact of Ventricular SeptalDefect Diameter on Growth and Chest Infections in Children

Abstract

The ventricular septal defect (VSD) is a communication between the two ventricular cavitieswhich separates the two ventricular cavities, the right and the left which allows blood to pass from the left to the right side of the heart. It may be present as an isolated anomaly or in association with other complex malformations (Ooshima et al., 1995; Miyake et al., 2004). VSD is the most common cardiac malformation after the bicuspid aortic valve andmitral prolapse; it has been reported that 4% of asymptomatic neonatespresents small VSD after birth and that accounts for 25% of all congenital heart diseases worldwide and a slightly higher percentage 28.8% in Egypt (Tomita et al., 2001; Hanna et al., 2010). In VSD because of a left to right shunting of blood due to higher left ventricular systolic pressure, there is pulmonary overcirculation and pulmonary oedema. The pulmonary oedema leads to circulation insufficiency and pulmonary circulation congestion thus becomes a nidus of infections for the lower respiratory tract (Bhatt et al., 2004; Patel, 2004). The high prevalence of VSD, its contribution to infant morbidity and mortality and the association with poor growth in infancy are ongoing challenges in caring for these infants as growth is fundamental to pediatric care and often used as a gauge to measure the infant’s health and well-being (Eskedal et al., 2008). The aim of our study was to determine the ventricular septal defect diameter to aortic root diameter ratio (DVSD/DAR) as a noninvasive index for assessment of the severity of VSD and its correlation to growth and chest infections. This study was performed at the pediatric cardiology clinic and echocardiography unit, children's hospital, Ain Shams University from February 2015 to February 2016 on 40 patients with ventricular septal defect. Forty healthy age matched children served as a control group