Regional functional depression immediately after ventricular septal defect closure. Academic Article uri icon

Overview

abstract

  • Left ventricular ejection is depressed immediately after repair of ventricular septal defect (VSD). Postrepair functional depression seen after VSD closure could result from a reduction in preload. However, other mechanisms could be at work. Functional depression could also be caused by closure of a low-impedance path for left ventricular ejection, the introduction of a stiff akinetic patch, or the operation itself. We reasoned that functional depression mediated by changes in preload or afterload should symmetrically affect end-diastole and end-systole, whereas depression resulting from changes in septal mechanics should be localized. We, therefore, performed segmental wall-motion analysis on intraoperative echocardiograms from patients undergoing VSD and atrial septal defect repair. After VSD closure, there was an asymmetric change in left ventricular end-systolic segment length and a decrease in fractional segment shortening localized to the septal and lateral walls, whereas patients with atrial septal defect had a symmetric increase in fractional shortening. These results suggest that acute functional depression after VSD repair is a result of localized impairment of septal function.

publication date

  • October 1, 2004

Research

keywords

  • Cardiac Surgical Procedures
  • Heart Septal Defects, Atrial
  • Heart Septal Defects, Ventricular
  • Ventricular Outflow Obstruction

Identity

Scopus Document Identifier

  • 4644233929

Digital Object Identifier (DOI)

  • 10.1016/j.echo.2004.06.021

PubMed ID

  • 15452473

Additional Document Info

volume

  • 17

issue

  • 10