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Journal of the Korean Pediatric Society 1994;37(11):1565-1573.
Published online November 15, 1994.
Clinical Significance of Septal Malalignment in Ventricular Septal Defect
Wan-Yong Shin, Sa-Jun Chung, Chang-Il Ahn
Department of Pediatrics, College of Medicine, Kyunghee University, Seoul, Korea
심신중격결손에 있어서 중격정렬이상의 임상적 의의
신완용, 정사준, 안창일
경희대학교 의과대학 소아과학교실
Abstract
Purpose
: Depending on the direction and degree of the septal deviation, the patient with malalignment-type VSD present with a variety of clinical syndrome. It is the purpose of this study to examine clinical characteristics of malalignment-type VSD, and to emphasize the clinical significance of septal malalignment in VSD and thus to increase the awareness for it.
Methods
: We analyzed echocardiographic or cardic catheterization and angiographic findings of 85 patients who were diagnosed as malalignment-type VSD at the department of pediatrics, Chonnam University Hospital between July 1990 and September 1992.
Results
: 1) Among 85 patients with malalignment-type VSD, there were 52 cases (61.2%) of Fallot-type VSD, 14 cases (16.5%) of Eisenmenger-type VSD, 19 cases (22.3%) of coarctation-type VSD. 2) All the 85 cases with malalignment-type VSD had the infundibular defects, and perimembranous infundibular VSD was most frequently associated with septal malalignment. 3) There was no prolapsing valve in all the cases with malalignment-type VSD. 4) Pulmonary hypertension was observed in all the cases with Eisenmenger-type and coarctation-type VSD. 5) Among the 19 cases with coarctation-type VSD, 8 cases (42.1%) were associated with coarctation of the aorta, and 3 cases (15.8%) with interrupted aortic arch.
Conclusion
: We conclude that septal malalignment in VSD has considerable clinical significance. Therefore, the authors believe that we should always consider the presence or absence of septal malalignment, in addition to the size and location of defect at the time of diagnostic evaluation of VSD, especially in the Koreans showing high incidence of infundibular VSD.
Key Words: Ventricular septal defect, Malalignment


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