Natural history of ventricular septal defect with right-sided aortic arch.
The natural history of 14 patients with ventricular septal defect and right-sided aortic arch is reviewed. Patients are divided into two groups. Group A consisted of 10 patients, all of whom developed progressive infundibular stenosis; group B consisted of 4 patients, none of whom developed infundibular stenosis. The clinical features, x-rays, electrocardiograms, haemodynamic data, and angiocardiograms in these two groups are compared. The right ventricular cine-angiocardiogram seems to be helpful in differentiating the course of the two groups. The patients who developed progressive infundibular stenosis showed an abnormal right ventricular cine-angiocardiogram even in the absence of obstruction. Various aetiological factors for the development of infundibular stenosis are discussed. The importance of medical management in group A patients is emphasized, even though all of them presented in infancy in congestive heart failure. The role of propranolol in preventing cyanotic spells in group A patients is also discussed.
D000790:Angiocardiography; D001013:Aorta, Thoracic / Q000002:abnormalities*; D002648:Child; D002675:Child, Preschool; D002932:Cineangiography; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000000981:diagnostic imaging; D003490:Cyanosis / Q000188:drug therapy; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D006333:Heart Failure / Q000209:etiology; D006345:Heart Septal Defects, Ventricular / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011433:Propranolol / Q000627:therapeutic use
D011433:Propranolol