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Vol. 60. Issue 2.
Pages 148-152 (1 February 2004)
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Vol. 60. Issue 2.
Pages 148-152 (1 February 2004)
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Seguimiento de las comunicaciones interventriculares de larga evolución
Follow-up of longstanding ventricular septal defects
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A. Ibáñez Fernández, J.J. Díez Tomás, J. Barreiro Daviña*, J. Rodríguez Suárez, M. Crespo Hernández
Departamento de Pediatría. Hospital Universitario Central de Asturias. Oviedo. España. 985-108515
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Objetivo

La comunicación interventricular (CIV) es la cardiopatía congénita diagnosticada más frecuentemente. El pronóstico, en general, es bueno. El objetivo de este trabajo es llevar esa idea al pediatra general

Material y métodos

Se revisa la evolución de 81 casos de comunicación interventricular. Se excluyeron las que cerraron de forma espontánea en los primeros 12 meses de vida y las que formaban parte de un síndrome polimalformativo o de una cardiopatía compleja

Resultados

La localización perimembranosa, en la cual se englobaron todas las que afectaban principalmente al septo membranoso, independientemente de que tuviesen alguna extensión hacia tejidos vecinos, se encontró en el 66,7% de casos, la muscular en el 29,6% y mixta en el 3,7 %. Predominó la primera en las de tamaño grande y mediano. En las grandes y perimembranosas ha sido característico el soplo holosistólico; en las pequeñas musculares, el soplo solamente se oía en la primera mitad de la sístole. Se encontró retraso en el desarrollo ponderal en el 45,8 % de los defectos grandes, sin que fuera apreciable en la talla. En general observamos tendencia al cierre parcial y a la mejoría. Precisaron cierre quirúrgico el 9,8%

Conclusiones

La habitual tendencia al cierre parcial o total de la mayoría de las CIV hace que el pronóstico de este defecto sea, generalmente, bueno

Palabras clave:
Comunicación interventricular
Objective

Ventricular septal defect is the most frequently diagnosed congenital heart defect. The prognosis is usually good. The aim of this study was to describe this idea to general pediatricians

Material and methods

We review the follow-up of 81 patients with ventricular septal defect. Defects that spontaneously closed in the first 12 months of life and those that formed part of a malformative syndrome or a complex congenital heart defect were excluded

Results

Localization was perimembranous, including all defects affecting mainly the septal membrane independent of whether the surrounding tissues were involved, in 66.7%, muscular in 29.6 % and mixed in 3.7 %. Perimembranous position was more frequent among large and medium-sized defects. Large and perimembranous defects were characterized by holosystolic murmur; in small, muscular defects, murmur was cut off in mid-systole. In 45.8% of large defects, weight development was delayed, but there was no appreciable effect on height. Generally we observed a tendency to partial closure and to improvement. Surgical closure was required in 9.8%

Conclusions

Because of the trend to partial or complete spontaneous closure, the prognosis of ventricular septal defect is generally good

Key words:
Ventricular septal defect
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Copyright © 2004. Asociación Española de Pediatría
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