Regional functional depression immediately after ventricular septal defect closure

Academic Article

Abstract

  • Left ventricular ejection is depressed immediately after repair of ventricular septal defect (VSD). Postrepair functional depression seen after VSD closure could result from a reduction in preload. However, other mechanisms could be at work. Functional depression could also be caused by closure of a low-impedance path for left ventricular ejection, the introduction of a stiff akinetic patch, or the operation itself. We reasoned that functional depression mediated by changes in preload or afterload should symmetrically affect end-diastole and end-systole, whereas depression resulting from changes in septal mechanics should be localized. We, therefore, performed segmental wall-motion analysis on intraoperative echocardiograms from patients undergoing VSD and atrial septal defect repair. After VSD closure, there was an asymmetric change in left ventricular end-systolic segment length and a decrease in fractional segment shortening localized to the septal and lateral walls, whereas patients with atrial septal defect had a symmetric increase in fractional shortening. These results suggest that acute functional depression after VSD repair is a result of localized impairment of septal function.
  • Authors

    Digital Object Identifier (doi)

    Author List

  • Quinn TA; Cabreriza SE; Blumenthal BF; Printz BF; Altmann K; Glickstein JS; Snyder MS; Mosca RS; Quaegebeur JM; Holmes JW
  • Start Page

  • 1066
  • End Page

  • 1072
  • Volume

  • 17
  • Issue

  • 10