title: Isolated ventricular septal defect in adults. Clinical and haemodynamic findings.
abstract: Clinical and haemodynamic findings were reviewed in 109 consecutive patients in whom an isolated ventricular septal defect was diagnosed after the age of 15 years (range 15-65 years). Most patients had no or minor cardiac symptoms. Based on the left to right shunt size and pulmonary pressure, 32 (29%) patients had large and 75 (69%) small ventricular septal defects, whereas in two (2%) patients data were insufficiently complete for determining the size. The anatomical location was membranous in 92% and muscular in 8% of the 51 patients in whom this could be assessed from a left ventricular angiogram or the surgeon's report of a subsequent operation, or both. Nine (8%) patients had developed the Eisenmenger syndrome, 12 had aortic regurgitation, and 16 (15%) had bacterial endocarditis, the incidence of the latter being 5.7 per 1000 patient years. Of the 34 (31%) patients who underwent surgery, five (15%) died while in hospital. In contrast with reports from paediatric series our study in adults showed a predominance of small ventricular septal defects and a high frequency of irreversible pulmonary hypertension and serious complications, such as aortic regurgitation and bacterial endocarditis. Thus ventricular septal defects in adults should--regardless of symptoms--be looked on as potentially serious.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000150:complications; D001794:Blood Pressure; D004697:Endocarditis, Bacterial / Q000150:complications; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D006346:Heart Septum / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged