Cross-sectional and M-mode echocardiographic study on ventricular septal defect.

One hundred and eight patients with ventricular septal defect (VSD) including 20 operated patients were studied with real time cross-sectional echocardiography combined with M-mode echocardiography. The subjects were divided into 3 groups according to the cross-sectional echocardiographic findings. Group 1 included 34 patients in whom the defect area of interventricular septum (IVS) was demonstrated and they were diagnosed as VSD solely with this method. The majority of the patients in this group showed marked pulmonary hypertension and severe cardiac symptoms. Group 2 consisted of 13 patients who showed abruptly posterior movement of IVS toward the left ventricular cavity at early diastole and were suspected of VSD. Group 3 consisted of 41 patients with VSD showing normal cross-sectional echocardiograms without echo discontinuity of IVS. This group had a small defect of IVS with near normal pulmonary artery pressure. The analysis of cross-sectional echocardiogram combined with M-mode echocardiogram and the data of other cardiac examinations revealed that group 1 showed a larger left-to-right shunt at the ventricular level, severer pulmonary hypertension and more marked heart enlargement than groups 2 and 3. The patients with visualized defect of IVS had severe cardiac signs and symptoms and were indicated for the cardiac surgery. In the postoperative patients, the patch echo was clearly recognized as a linear strong echo. Real time cross-sectional echocardiography is available to visualize directly the defect of IVS in the majority of the patients with VSD and to estimate the condition of patients with this lesion.