Ventricular septal defect cardiac catheterization

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Keri Shafer, M.D. [2],Priyamvada Singh, MBBS

Cardiac Catheterization

Criteria for Cardiac Catheterization

1. The Mayo Clinic recommends cardiac catheterization for all adults and adolescents to quantify the degree of pulmonary vascular obstruction, except in those who clearly appear to have a small VSD.

2. Infants suspected of having a large defect should undergo cardiac catheterization in the first year of life which should allow surgical correction prior to the onset of permanent pulmonary vascular obstructive disease.

2008 ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)[1]

2008 ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)^[1]

Recommendations for Cardiac Catheterization (DO NOT EDIT)^[1]

Class I
“1. Cardiac catheterization to assess the operability of adults with ventricular septal defect (VSD) and pulmonary arterial hypertension (PAH) should be performed in an adult congenital heart disease (ACHD) regional center in collaboration with experts. (Level of Evidence: C) ”

Class IIa
“1. Cardiac catheterization can be useful for adults with VSD in whom noninvasive data are inconclusive and further information is needed for management. Data to be obtained include the following:”
“a. Quantification of shunting. (Level of Evidence: B)”
“b. Assessment of pulmonary pressure and resistance in patients with suspected PAH. Reversibility of PAH should be tested with various vasodilators. (Level of Evidence: B) ”
“c. Evaluation of other lesions such as aortic regurgitation (AR) and double-chambered right ventricle. (Level of Evidence: C) ”
“d. Determination of whether multiple VSDs are present before surgery. (Level of Evidence: C)”
“e. Performance of coronary arteriography is indicated in patients at risk for coronary artery disease. (Level of Evidence: C)”
“f. VSD anatomy, especially if device closure is contemplated. (Level of Evidence: C)”

Recommendation for Interventional Catheterization (DO NOT EDIT) ^[1]

Class IIb
“1. Device closure of a muscular VSD may be considered, especially if the VSD is remote from the tricuspid valve and the aorta, if the VSD is associated with severe left-sided heart chamber enlargement, or if there is PAH. (Level of Evidence: C)”

References

↑ ^1.0 ^1.1 ^1.2 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). “ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons”. J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.

Template:WikiDoc Sources

[pmid19038677-1] 1.0 ^1.1 ^1.2 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). “ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons”. J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.

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