title: Aneurysm of the ventricular membranous septum: serial echocardiographic studies.
abstract: OBJECTIVE
  The aim of this article is to examine the frequency, timing of formation of aneurysm of the ventricular membranous septum (AVMS), and prognosis in patients with a perimembranous ventricular septal defect (VSD).
  
  
  METHODS
  One hundred forty-eight patients were diagnosed with a perimembranous VSD within 90 days after birth. They were classified into three groups: Group I, spontaneous closure; Group II, open; Group III, surgical closure. They were also divided into two further groups: 75 patients with congestive heart failure (CHF) and 73 patients without that.
  
  
  METHODS
  An AVMS was observed by two-dimensional echocardiography, and spontaneous closure of the VSD was confirmed by color Doppler.
  
  
  RESULTS
  An AVMS was formed in 69 (47%) of 148 patients: 50% in Group I, 66% in Group II, 15% in Group III. The timing of AVMS formation was at a median age of 6 months. In 14% of patients, AVMS was formed within 3 months of age. The frequency of AVMS at the time of the initial echocardiogram was low in patients with CHF (odds ratio, 3.23; 95% confidence interval, 1.19-8.79 p = 0.017).
  
  
  CONCLUSIONS
  We believe that AVMS formation is related to avoidance of surgical closure during early infancy in patients with a perimembranous VSD, because the frequency of AVMS during early infancy is low in patients with CHF.
authors.affiliation: Department of Pediatrics, Kinki University School of Medicine, Osaka-Sayama, Japan. miyake@kpcd.med.kindai.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Miyake
authors.forename: T
authors.initials: T
authors.lastname: Shinohara
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamura
authors.forename: T
authors.initials: T
authors.lastname: Fukuda
authors.forename: H
authors.initials: H
authors.lastname: Tasato
authors.forename: K
authors.initials: K
authors.lastname: Toyohara
authors.forename: Y
authors.initials: Y
authors.lastname: Tanihira
mesh_terms: D006348:Cardiac Surgical Procedures; D004452:Echocardiography; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery; D006333:Heart Failure / Q000209:etiology; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging* / Q000601:surgery; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D007231:Infant, Newborn; D007564:Japan; D011183:Postoperative Complications / Q000209:etiology; D013223:Statistics as Topic; D013997:Time Factors; D016896:Treatment Outcome