Aneurysm of the ventricular membranous septum: serial echocardiographic studies.

OBJECTIVES

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).

PATIENTS: 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.