MedClips

When there are atrial septal defects (ASD) in children, the following three considerations should be considered for treatment planning: 1) The possibility of ASD shutting down by itself 2) Size of ASD and amount of blood shunt 3) In the indication of ASD closure, whether to perform surgery or percutaneous transcatheter Most ASD secundums are smaller than 6 mm in size, usually closed within 2 years and lasting up to 5 years. Therefore, if there is no symptom, it is not indications that the defect is prevented by the surgical procedure at a young age. If the size of the defect is moderate (6 to 8 mm) or large (> 8 mm), ASD secundum does not normally close on its own. However, since moderate, large ASD has the possibility of spontaneous closure, it is recommended to watch it until two years old on the assumption that there is no symptom. The risk of embolism and the severity of the procedure should be considered by preventing ASD. However, the small size of less than 6mm did no...

The patent ductus arteriosus is a case in which the obstructed pulmonary artery keeps open immediately after birth, and pulmonary vascular resistance is decreased and aortic blood flow enters the pulmonary artery. Frequency is two times higher in girls than in boys and is well accompanied by rubella infection in early pregnancy. Patients with patent ductus arteriosus tend to have a high incidence in preterm infants as in this case, 10% of congenital heart disease is accompanied by patent ductus arteriosus. Symptoms are mild, almost asymptomatic, and heart murmurs may be detected with a stethoscope. If the patency of the ductus arteriosus is large, it may be accompanied by heart failure and growth retardation from infancy. Typical clinical findings include wide pulse pressure, leaping veins, and sustained mechanical heart murmurs at the left sternal level. In the case of neonatal or pulmonary arterial hypertension, only systolic noise may be heard. In the chest X-ray, the heart size i...

Basically, a therapeutic approach to the opening of the patent ductus begins with determining whether the progress is to be followed by ongoing observation or by active intervention. 2) severe hypertension in the left heart due to overload of the left heart, 3) reversible pulmonary hypertension in the left atrium, 4) reversible hypertension in the past, If endocarditis is present, intervention or surgical closure is recommended. After closure, symptoms are alleviated and irreversible pulmonary hypertension can be prevented from progressing.  The incidence of irreversible severe pulmonary arterial hypertension is a contraindication to closure, which increases the risk of the procedure, does not improve survival after the procedure, and is associated with pulmonary arterial hypertension, Because it is necessary for.  It is not easy to decide whether to open a small-sized patent ductus arteriosus. Experts advise that it is beneficial to perform procedures regardless of size i...

Ventricular septal defect (VSD) is one of the most common congenital heart malformations. It may be present as a single anomaly but may be accompanied by other congenital cardiac anomalies. It is divided into Perimembranous, Muscular, and Subarterial type. Perimembranous type is the most common type (70%). Subarterial type is indications for surgical treatment regardless of defect size. Because defects appear near the LVOT, they can cause aortic valve prolapse and ultimately cause aortic regurgitation. The clinical manifestations of VSD depend on the size of the defect and the pulmonary blood flow. However, in moderate to large VSD, symptoms such as tachypnea, poor oral intake, poor weight gain, and tachycardia are present. In moderate to large VSDs, murmurs can also be heard. Low-pitched pansystolic murmur may appear at the lesion site and mid-diastolic rumbling murmur may appear at apex. Also, as blood flow to the pulmonary blood vessels increases, the size of P2 increases. LV hy...

Let's look at the Eisenmenger SD in chronological order. In the early phase, pulmonary arterial pressure rises with a noticeable increase in pulmonary blood flow. If this condition persists, it develops into a pulmonary vascular disease with pathological changes. This results in pulmonary hypertension. Pathological changes occur in small pulmonary arterioles and muscular arteries, and are divided into Grade I-VI according to histologic findings. In the early stage, medial hypertrophy occurs in Grade I, hyperplasia of intima in II, and obliteration in III. In IV, arterial dilation, V and VI eventually result in plexiform lesion, angiomatoid formation and fibrinoid necrosis. However, in the clinical setting, pulmonary artery resistance, pulmonary artery resistance, and systemic vascular resistance are observed rather than clinical course according to these histological changes. The retrospective study showed that the symptoms, syncope, poor functional class, low oxygen saturation (...