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Holes and channels between the ventricles revisited

Published online by Cambridge University Press:  23 September 2014

Adrian Crucean ,
William J. Brawn ,
Diane E. Spicer ,
Rodney C. Franklin  and
Robert H. Anderson
Adrian Crucean
Affiliation:
Department of Paediatric Cardiac Surgery, Birmingham Children’s Hospital, Birmingham, United Kingdom
William J. Brawn
Affiliation:
Department of Paediatric Cardiac Surgery, Birmingham Children’s Hospital, Birmingham, United Kingdom
Diane E. Spicer
Affiliation:
Department of Pediatric Cardiology, University of Florida, Gainesville, Florida; and Congenital Heart Institute of Florida, St Petersburg, Florida, United States of America
Rodney C. Franklin
Affiliation:
Department of Paediatric Cardiology, Royal Brompton Hospital, London, United Kingdom
Robert H. Anderson*
Affiliation:
Department of Paediatric Cardiac Surgery, Birmingham Children’s Hospital, Birmingham, United Kingdom Institute of Genetic Medicine, Newcastle University, Newcastle, United Kingdom
*
Correspondence to: Professor R. H. Anderson, 60 Earlsfield Road, London SW18 3DN, United Kingdom. 00-44-20-8870-4368; E-mail: [email protected]
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Abstract

Background

Although holes, or channels, between the ventricles are the commonest congenital cardiac malformations, there is still no consensus as to how they can best be described and categorised. So as to assess whether it is possible to produce a potentially universally acceptable system, we have analysed the hearts categorised as having ventricular septal defects in a large archive held at Birmingham Children’s Hospital.

Materials and methods

We analysed all the hearts categorised as having isolated ventricular septal defects, or those associated with aortic coarctation or interruption in the setting of concordant ventriculo-arterial connections, in the archive of autopsied hearts held at Birmingham Children’s Hospital, United Kingdom.

Results

We found 147 hearts within the archive fulfilling our criterions for inclusion. All could be classified within one of three groups depending on their borders as seen from the right ventricle. To provide full description, however, it was also necessary to take account of the way the defects opened to the right ventricle, and the presence or absence of alignment between the septal components.

Conclusions

By combining information on the phenotypic specificity defined on the basis of their borders, the direction of opening into the right ventricle, and the presence or absence of septal malalignment, it proved possible to categorise all hearts examined within the archive of Birmingham Children’s Hospital. Our findings have necessitated creation of new numbers within the European Paediatric Cardiac Code.

Keywords

Ventricular septal defectClassificationInterventricular shuntingInlet defectSeptal malalignment
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 6 , August 2015 , pp. 1099 - 1110
Copyright
© Cambridge University Press 2014 

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