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VENTRİKÜLER SEPTAL DEFEKT TANISI, BOYUT VE TİPLERİ, KOMPLİKASYONLARI VE SPONTAN KAPANMA ORANLARI COVİD-19 PANDEMİSİNDEN ETKİLENDİ Mİ?

Year 2023, Volume: 30 Issue: 4, 738 - 745, 30.12.2023
https://doi.org/10.17343/sdutfd.1357263

Abstract

Amaç
Polikliniğimize yönlendirilen hastalardan ventriküler
septal defekt tespit edilenlerin sayısı, ventriküler septal
defekt yeri ve boyutu, yol açtığı komplikasyonlar,
medikal, cerrahi ya da spontan kapanma olasılığı
incelenmiş, Covid-19 pandemisi koşullarında, rutin
poliklinik muayene sayılarında ve VSD tanısı koyma
oranında bir farklılık olup olmadığı, pandemi öncesi
verilerimiz ile kıyaslanmıştır.
Gereç ve Yöntem
2018-2022 yılları arasında hekime, göğüs ağrısı,
çarpıntı, çabuk yorulma, nefes almada zorlanma,
bayılma gibi semptomlar veya kalp dışı herhangi bir
şikayet ile başvuru sırasında rutin muayenede üfürüm
duyulması nedeniyle yapılan transtorasik ekokardiyografi
sonuçları değerlendirilmiştir.
Bulgular
Pandemi öncesi 2018-2020 yılları arasındaki ekokardiyografi
yapılan 16362 hastanın 91’inde (grup 1),
pandemi dönemi olan 2020-2022 yılları arasında ekokardiyografi
yapılan 14248 hastanın 202’sinde (grup
2), ventriküler septal defekt görülmüş olup, pandemi
döneminde ventriküler septal defektli hasta oranının
daha fazla olması yönünde anlamlıdır (p <0.001).
Ventriküler septal defektlerin izleminde çeşitli komplikasyonlar
gelişebilmektedir. Total olarak tüm komplikasyonlara
sayı olarak bakıldığında pandemi öncesi
dönemde komplikasyon oranı istatistiksel olarak anlamlı
derecede daha fazladır (p=0.003). Ancak gelişen
komplikasyonlar ayrı ayrı değerlendirildiğinde sadece
ventriküler septal anevrizma gelişimi açısından pandemi
öncesi grupta (grup 1) daha fazla oranda olması
yönünde anlamlı fark saptandı (p=0.002). Diğer komplikasyonlar
açısından anlamlı fark saptanmamıştır.
Sonuç
Hasta sayılarının benzer olması bize pediatrik kardiyoloji
poliklinik başvuru sayılarında, pandemi koşullarında
dahi ciddi bir azalma olmadığını kanıtlamıştır.
Ancak ventriküler septal defekt tanı alma sıklığının
pandemi döneminde daha fazla oranda olması, bu
dönemde hastaneye gerçekten pediatrik kardiyoloji
muayenesi gerektiren hastaların başvurmasından
kaynaklanabilir.

Ethical Statement

Yukarıda bilgileri verilen başvuru dosyası ile ilgili belgeler araştırmanın/çalışmanın gerekçe, amaç, yaklaşım ve yöntemleri dikkate alınarak incelenmiş ve UYGUN bulunmuş olup araştırmanın/çalışmanın başvuru dosyasında belirtilen merkezlerde gerçekleştirilmesinde etik ve bilimsel sakınca bulunmadığına toplantıya katılan etik kurul üye tam sayısının salt çoğunluğu ile karar verilmiştir.

Supporting Institution

S.B.Ü. ANTALYA EĞİTİM VE ARAŞTIRMA HASTANESİ KLİNİK ARAŞTIRMALAR ETİK KURULU

Project Number

12/9

References

  • 1. Hofman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39:1890–1900
  • 2. Eroğlu AG, Oztunç F, Saltik L, Bakari S, Dedeoğlu S, Ahunbay G. Evolution of ventricular septal defect with special reference to spontaneous closure rate, subaortic ridge and aortic valve prolapse. Pediatr Cardiol 2003;24:31–35
  • 3. Erdem S, Ozbarlas N, Küçükosmanoğlu O, Poyrazoğlu H, Salih OK. Long term follow-up of 799 children with isolated ventricular septal defects. Turk Kardiyol Dern Ars 2012; 40:22–25
  • 4. Karadas U, Saylam G, Yılmaz N, Kir M, Kizilca Ö, Demircan T et al. Assessment of ventricular septal defects by real-time three-dimensional echocardiography and comparison with surgical measurements. Progress in Pediatric Cardiology 2022;66:10156
  • 5. Kazmi U, Sadiq M, Hyder SN. Pattern of ventricular septal defects and associated complications. J Coll Physicians Surg Pak 2009;19:342–345
  • 6. Chaudhry TA, Younas M, Baig A. Ventricular septal defect and associated complications. J Pak Med Assoc 2011; 61:1001–1004
  • 7. Cox K, Algaze-Yojay C, Punn R, Silverman N, The Natural and Unnatural History of Ventricular Septal Defects Presenting in Infancy: An Echocardiography-Based Review. Journal of the American Society of Echocardiography 2020;33(6):763-770
  • 8. Chivers S, Lotto AA. Isolated Ventricular Septal Defect. In: Raja, S. (eds) Cardiac Surgery. Springer, 2020;849–863
  • 9. Adan A, Eleyan L, Zaidi M, Ashry A, Dhannapuneni R, Harky A, Ventricular septal defect: diagnosis and treatments in the neonates: a systematic review. Cardiology in the Young 2021;31(5):756 - 761
  • 10. Atalay S, Tutar E, Ekici F, Naçar N. Spontaneous closure of small apical muscular ventricular septal defects. The Turkish Journal of Pediatrics 2005;47:247-250
  • 11. Zhang J, Ko JM, Guileyardo JM, Roberts WC. A review of spontaneous closure of ventricular septal defect. Proc Bayl Univ Med Cent 2015;28(4):516-20.
  • 12. Sun J, Sun K, Chen S, Yao L, Zhang Y. A new scoring system for spontaneous closure prediction of perimembranous ventricular septal defects in children. PLoS One 2014;9(12);e113822
  • 13. Wu MH, Wang JK, Lin MT et al. Ventricular septal defect with secondary left ventricular-to-right atrial shunt is associated with a higher risk for infective endocarditis and a lower late chance of closure. Pediatrics 2006;117:e262–e267
  • 14. James H. Moller and Julian I.E.Hoffman. Ventricular septal defects. In: Daniel J. Penny. Pediatric Cardiovascular Medicine (2th Ed). Wiley & Blackwell, 2012;328-342.
  • 15. Miyake T, Shinohara T, Inoue T, Marutani S, Takemura T. Spontaneous closure of muscular trabecular ventricular septal defect: comparison of defect positions. Acta Paediatr 2011;100:e158–e162
  • 16. Xinyang L, Ren W, Song G, Zhang X. Prediction of spontaneous closure of ventricular septal defect and guidance for clinical follow-up. Clinical Cardiology 2019; 42:536–541.
  • 17. Zhao Q, Niu C, Liu F, Wu L, Ma X, Huang G. Spontaneous Closure Rates of Ventricular Septal Defects 6750 Consecutive Neonates. The American Journal of Cardiology 2019;124(4):613-617
  • 18. Miyake T. A review of isolated muscular ventricular septal defect. World Journal of Pediatrics 2020;16:120–128
  • 19. Gelehrter S, Ensing G. Ventricular septal defect, In: Echocardiography in Pediatric and Adult Congenital Heart Disease. USA Lippincott Williams & Wilkins, 2010;158-175
  • 20. Stout K, Daniels C , Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM, at all. AHA/ACC Guideline for the Management of Adults with Congenital Heart Disease. Journal Of The American College Of Cardiology 2018;73:12
  • 21. Park MK. Ventricular septal defect. In: Pediatric Cardiology for Practitioners (5.th Ed), Philadelphia, Mosby Elsevier, 2008; 212-221
  • 22. Rubio A, Lewin M. Ventricular Septal Defects. In: Moss and Adams’ Heart Disease in Infants, Children, and Adollescents (8th.Ed) USA Lippincott Williams & Wilkins, 2013; 713-721
  • 23. Meberg A, Otterstad JE, Frøland G, Lindberg H, Sørland SJ. Outcome of congenital heart defect-a population-based study. ActaPaediatr 2000; 89:1344–1351
  • 24. Bernstein D. Ventricular Septal Defects. In: Nelson Textbook of Pediatrics (19th Ed) USA Elsevier Saunders, 2011;1556-1559
  • 25. Erol O, Sevket O, Keskin S, Yazıcıoğlu HF, Gül A. Natural history of prenatal isolated muscular ventricular septal defects. J Turk Ger GynecolAssoc 2014;15:96–99
  • 26. Miyake T, Shinohara T, Nakamura Y, Fukuda T, Hasato T, Toyohara K et al. Aneurysm of the Ventricular Membranous Septum: Serial Echocardiographic Studies. Pediatr Cardiol 2004;25:585–589.
  • 27. Ramaciotti C, Keren A, Silverman NH. Importance of perimembranous ventricular septal aneurysm in the natural history of isolated perimembranous ventricular septal defect. Am J Cardiol 1986; 57:268–272
  • 28. Wu MH, Wu JM, Chang C et al. Implication of aneurysmal transformation in isolated perimembranous ventricular septal defect. Am J Cardiol 1993;72:596–601
  • 29. Wu MH, Wang JK, Lin MT et al. Ventricular septal defect with secondary left ventricular -to -right atrial shunt is associated with a higher risk for infectiv eendocardit is and a lower late chance of closure. Pediatrics 2006; 117:e262–e267
  • 30. WHO. Coronavirus disease (COVID-19) Situation Report-128 Data as received by WHO from national authorities by 10:00 CEST-27 May 2020. [Internet]. Available from: https://www. who.int/docs/default-source/coronaviruse/situation-reports/ 20200622-covid-19-sitrep-154
  • 31. T.C. Sağlık Bakanlığı. COVID-19 Bilgilendirme Platformu [Internet]. Available from: https://covid19bilgi.saglik.gov.tr/tr/
  • 32. T.C. Sağlık Bakanlığı. COVID-19 (SARS-CoV2 Enfeksiyonu) Rehberi (Bilim Kurulu Çalışması) [Internet] T.C. Sağlık Bakanlığı. Nisan 2020. Available from: https://covid19bilgi.saglik.gov. tr/tr/
  • 33. Bakhshi H, Gattani R, Ekanem E, at al. Ventricular septal rüptüre and cardiogenic shock complicating STEMI during COVID- 19 pandemic: An old foere-emerges. Heart&Lung, 2020; 50(2), 292–295.
  • 34. Miyake T, Shinohara T, Fukuda T, Ikeoka M, Takemura T. Spontaneous closure of perimembranous ventricular septal defect after school age. Pediatr Int 2008 50:632–6
  • 35. Forbus GA, Shirali GS. Anomalies of the Ventricular Septum. In:Echocardiography in Pediatric and Congenital Heart Disease From Fetus to Adult. USA, Wiley-Blackwell, 2009;175-187
  • 36. Weng KP, Huang SH, Lin CC, Huang SM, Chien KJ, Ger LP, Hsieh KS. Re appraisal of left ventricular to right atrial (LV-RA) shunt in pediatric patients with isolated perimembranous ventricular septal defect. Circ 2008; J 72:1487
  • 37. Layangool T, Kirawittaya T, Sangtawesin C, Kojaranjit V, Makarapong P, Pechdam- rongsakul A. Natural aortic valve complications of ventricular septal defect: a prospective cohort study. J Med Assoc Thai 2008;91 Suppl 3:S53-9.
  • 38. Tweddell JS, Pelech AN, Frommelt PC, Ventricular Septal Defect and Aortic Valve Regurgitation: Pathophysiology and Indications for Surgery. Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2006;9(1):47-152
  • 39. Eroglu AG, Ugan Atik S, Sengenc E, Cig E, Saltik IL, Oztunc F, Evaluation of Ventricular Septal Defect with Special Reference to the Spontaneous Closure Rate, Subaortic Ridge, and Aortic Valve Prolapse II.Pediatr Cardiol 2017; 38:915–921
  • 40. Dakkak W, Oliver T, Ventricular Septal Defect, In: StatPearls Publishing, Treasure Island (FL). 2023. PMID: 29261884

ARE VENTRICULAR SEPTAL DEFECT DIAGNOSES IN PEDIATRIC AGE GROUP AFFECTED BY THE COVID-19 PANDEMIC?

Year 2023, Volume: 30 Issue: 4, 738 - 745, 30.12.2023
https://doi.org/10.17343/sdutfd.1357263

Abstract

Objective
Within the patients who were referred to our outpatient
clinic, the number of those detected with a ventricular
septal defect location and size of the defect, the
complications it caused, the possibility of medical,
surgical or spontaneous closure were examined
and it has been compared with our pre-pandemic
data whether there is a difference in the number of
routine outpatient clinic examinations and the rate
of diagnosis of ventricular septal defect under the
conditions of the Covid-19 pandemic.
Material and Method
The results of transthoracic echocardiography made
between the years 2018-2022 were evaluated which
were performed due to hearing a cardiac murmur
during routine examination of patients with symptoms
such as chest pain, palpitations, fatigue, difficulty
breathing, fainting, or any non-cardiac complaint.
Results
Ventricular septal defect was observed in 91 of 16362
patients (group 1) who underwent echocardiography
between 2018 and 2020 before the pandemic, and
in 202 of 14248 patients (group 2) who underwent
echocardiography between 2020 and 2022, during
the pandemic period. It is significant in that the patient
rate is higher (p <0.001). Various complications may
develop during the follow-up of ventricular septal
defects. Considering the total number of complications,
they were statistically significantly higher in the prepandemic
period (p=0.003). However, when the
developing complications were evaluated separately,
a significant difference was detected only in terms
of ventricular septal aneurysm development, with
a higher rate in the pre-pandemic group (p=0.002).
No significant difference was found in terms of other
complications.
Conclusion
The similar number of patients has proven to us that
there is no serious decrease in the number of pediatric
cardiology outpatient clinic admissions, even under
pandemic conditions. However, the higher frequency
of diagnosis of ventricular septal defect during the
pandemic period may be due to the fact that patients
who actually require pediatric cardiology examination
applied to the hospital during this period.

Project Number

12/9

References

  • 1. Hofman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39:1890–1900
  • 2. Eroğlu AG, Oztunç F, Saltik L, Bakari S, Dedeoğlu S, Ahunbay G. Evolution of ventricular septal defect with special reference to spontaneous closure rate, subaortic ridge and aortic valve prolapse. Pediatr Cardiol 2003;24:31–35
  • 3. Erdem S, Ozbarlas N, Küçükosmanoğlu O, Poyrazoğlu H, Salih OK. Long term follow-up of 799 children with isolated ventricular septal defects. Turk Kardiyol Dern Ars 2012; 40:22–25
  • 4. Karadas U, Saylam G, Yılmaz N, Kir M, Kizilca Ö, Demircan T et al. Assessment of ventricular septal defects by real-time three-dimensional echocardiography and comparison with surgical measurements. Progress in Pediatric Cardiology 2022;66:10156
  • 5. Kazmi U, Sadiq M, Hyder SN. Pattern of ventricular septal defects and associated complications. J Coll Physicians Surg Pak 2009;19:342–345
  • 6. Chaudhry TA, Younas M, Baig A. Ventricular septal defect and associated complications. J Pak Med Assoc 2011; 61:1001–1004
  • 7. Cox K, Algaze-Yojay C, Punn R, Silverman N, The Natural and Unnatural History of Ventricular Septal Defects Presenting in Infancy: An Echocardiography-Based Review. Journal of the American Society of Echocardiography 2020;33(6):763-770
  • 8. Chivers S, Lotto AA. Isolated Ventricular Septal Defect. In: Raja, S. (eds) Cardiac Surgery. Springer, 2020;849–863
  • 9. Adan A, Eleyan L, Zaidi M, Ashry A, Dhannapuneni R, Harky A, Ventricular septal defect: diagnosis and treatments in the neonates: a systematic review. Cardiology in the Young 2021;31(5):756 - 761
  • 10. Atalay S, Tutar E, Ekici F, Naçar N. Spontaneous closure of small apical muscular ventricular septal defects. The Turkish Journal of Pediatrics 2005;47:247-250
  • 11. Zhang J, Ko JM, Guileyardo JM, Roberts WC. A review of spontaneous closure of ventricular septal defect. Proc Bayl Univ Med Cent 2015;28(4):516-20.
  • 12. Sun J, Sun K, Chen S, Yao L, Zhang Y. A new scoring system for spontaneous closure prediction of perimembranous ventricular septal defects in children. PLoS One 2014;9(12);e113822
  • 13. Wu MH, Wang JK, Lin MT et al. Ventricular septal defect with secondary left ventricular-to-right atrial shunt is associated with a higher risk for infective endocarditis and a lower late chance of closure. Pediatrics 2006;117:e262–e267
  • 14. James H. Moller and Julian I.E.Hoffman. Ventricular septal defects. In: Daniel J. Penny. Pediatric Cardiovascular Medicine (2th Ed). Wiley & Blackwell, 2012;328-342.
  • 15. Miyake T, Shinohara T, Inoue T, Marutani S, Takemura T. Spontaneous closure of muscular trabecular ventricular septal defect: comparison of defect positions. Acta Paediatr 2011;100:e158–e162
  • 16. Xinyang L, Ren W, Song G, Zhang X. Prediction of spontaneous closure of ventricular septal defect and guidance for clinical follow-up. Clinical Cardiology 2019; 42:536–541.
  • 17. Zhao Q, Niu C, Liu F, Wu L, Ma X, Huang G. Spontaneous Closure Rates of Ventricular Septal Defects 6750 Consecutive Neonates. The American Journal of Cardiology 2019;124(4):613-617
  • 18. Miyake T. A review of isolated muscular ventricular septal defect. World Journal of Pediatrics 2020;16:120–128
  • 19. Gelehrter S, Ensing G. Ventricular septal defect, In: Echocardiography in Pediatric and Adult Congenital Heart Disease. USA Lippincott Williams & Wilkins, 2010;158-175
  • 20. Stout K, Daniels C , Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM, at all. AHA/ACC Guideline for the Management of Adults with Congenital Heart Disease. Journal Of The American College Of Cardiology 2018;73:12
  • 21. Park MK. Ventricular septal defect. In: Pediatric Cardiology for Practitioners (5.th Ed), Philadelphia, Mosby Elsevier, 2008; 212-221
  • 22. Rubio A, Lewin M. Ventricular Septal Defects. In: Moss and Adams’ Heart Disease in Infants, Children, and Adollescents (8th.Ed) USA Lippincott Williams & Wilkins, 2013; 713-721
  • 23. Meberg A, Otterstad JE, Frøland G, Lindberg H, Sørland SJ. Outcome of congenital heart defect-a population-based study. ActaPaediatr 2000; 89:1344–1351
  • 24. Bernstein D. Ventricular Septal Defects. In: Nelson Textbook of Pediatrics (19th Ed) USA Elsevier Saunders, 2011;1556-1559
  • 25. Erol O, Sevket O, Keskin S, Yazıcıoğlu HF, Gül A. Natural history of prenatal isolated muscular ventricular septal defects. J Turk Ger GynecolAssoc 2014;15:96–99
  • 26. Miyake T, Shinohara T, Nakamura Y, Fukuda T, Hasato T, Toyohara K et al. Aneurysm of the Ventricular Membranous Septum: Serial Echocardiographic Studies. Pediatr Cardiol 2004;25:585–589.
  • 27. Ramaciotti C, Keren A, Silverman NH. Importance of perimembranous ventricular septal aneurysm in the natural history of isolated perimembranous ventricular septal defect. Am J Cardiol 1986; 57:268–272
  • 28. Wu MH, Wu JM, Chang C et al. Implication of aneurysmal transformation in isolated perimembranous ventricular septal defect. Am J Cardiol 1993;72:596–601
  • 29. Wu MH, Wang JK, Lin MT et al. Ventricular septal defect with secondary left ventricular -to -right atrial shunt is associated with a higher risk for infectiv eendocardit is and a lower late chance of closure. Pediatrics 2006; 117:e262–e267
  • 30. WHO. Coronavirus disease (COVID-19) Situation Report-128 Data as received by WHO from national authorities by 10:00 CEST-27 May 2020. [Internet]. Available from: https://www. who.int/docs/default-source/coronaviruse/situation-reports/ 20200622-covid-19-sitrep-154
  • 31. T.C. Sağlık Bakanlığı. COVID-19 Bilgilendirme Platformu [Internet]. Available from: https://covid19bilgi.saglik.gov.tr/tr/
  • 32. T.C. Sağlık Bakanlığı. COVID-19 (SARS-CoV2 Enfeksiyonu) Rehberi (Bilim Kurulu Çalışması) [Internet] T.C. Sağlık Bakanlığı. Nisan 2020. Available from: https://covid19bilgi.saglik.gov. tr/tr/
  • 33. Bakhshi H, Gattani R, Ekanem E, at al. Ventricular septal rüptüre and cardiogenic shock complicating STEMI during COVID- 19 pandemic: An old foere-emerges. Heart&Lung, 2020; 50(2), 292–295.
  • 34. Miyake T, Shinohara T, Fukuda T, Ikeoka M, Takemura T. Spontaneous closure of perimembranous ventricular septal defect after school age. Pediatr Int 2008 50:632–6
  • 35. Forbus GA, Shirali GS. Anomalies of the Ventricular Septum. In:Echocardiography in Pediatric and Congenital Heart Disease From Fetus to Adult. USA, Wiley-Blackwell, 2009;175-187
  • 36. Weng KP, Huang SH, Lin CC, Huang SM, Chien KJ, Ger LP, Hsieh KS. Re appraisal of left ventricular to right atrial (LV-RA) shunt in pediatric patients with isolated perimembranous ventricular septal defect. Circ 2008; J 72:1487
  • 37. Layangool T, Kirawittaya T, Sangtawesin C, Kojaranjit V, Makarapong P, Pechdam- rongsakul A. Natural aortic valve complications of ventricular septal defect: a prospective cohort study. J Med Assoc Thai 2008;91 Suppl 3:S53-9.
  • 38. Tweddell JS, Pelech AN, Frommelt PC, Ventricular Septal Defect and Aortic Valve Regurgitation: Pathophysiology and Indications for Surgery. Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2006;9(1):47-152
  • 39. Eroglu AG, Ugan Atik S, Sengenc E, Cig E, Saltik IL, Oztunc F, Evaluation of Ventricular Septal Defect with Special Reference to the Spontaneous Closure Rate, Subaortic Ridge, and Aortic Valve Prolapse II.Pediatr Cardiol 2017; 38:915–921
  • 40. Dakkak W, Oliver T, Ventricular Septal Defect, In: StatPearls Publishing, Treasure Island (FL). 2023. PMID: 29261884
There are 40 citations in total.

Details

Primary Language Turkish
Subjects Pediatric Cardiology
Journal Section Araştırma Makaleleri
Authors

Zehra Tamburacı 0000-0002-0821-3006

Project Number 12/9
Publication Date December 30, 2023
Submission Date September 8, 2023
Acceptance Date December 7, 2023
Published in Issue Year 2023 Volume: 30 Issue: 4

Cite

Vancouver Tamburacı Z. VENTRİKÜLER SEPTAL DEFEKT TANISI, BOYUT VE TİPLERİ, KOMPLİKASYONLARI VE SPONTAN KAPANMA ORANLARI COVİD-19 PANDEMİSİNDEN ETKİLENDİ Mİ?. Med J SDU. 2023;30(4):738-45.

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