Herzchirurgie pp 143-156 | Cite as

Ventrikelseptumdefekt

  • C. Huth
  • H.-E. Hoffmeister
Part of the Kirschnersche allgemeine und spezielle Operationslehre book series (OPERATIONSLEHRE, volume 6 / 2)

Zusammenfassung

Unabhängig von der Lokalisation im Ventrikelsep-tum sind Ventrikelseptumdefekte (VSD) mit einem mehr oder minder großen Links-rechts-Shunt verbunden. Dies führt zunächst zu einer volumenbedingten Rechtsherzbelastung und zu einer erhöhten Lungendurchblutung. Mit zunehmenden Shuntvolumen steigen jedoch auch die Drücke im rechten Ventrikel und in der A. pulmonalis bis zu einem Druckangleich in beiden Ventrikeln an. Dieser Druckangleich zwischen den Ventrikeln kann bei großen Defekten bereits primär bestehen. Sowohl die Druck- als auch die Volumenbelastung kann schon im Säuglings- und Kleinkindalter zu einer Herzinsuffizienz führen. Die pulmonale Hypervolämie bedingt eine höhere Infektneigung und führt, verbunden mit einer Drucksteigerung, zu proliferativen Gefäßveränderungen in der Lungenstrombahn und zu einer Widerstandserhöhung.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 1.
    Aaron BL, Lower RR (1975) Muscular ventricular septal defect repair made easy. Ann Thorac Surg 19: 568–570PubMedCrossRefGoogle Scholar
  2. 2.
    Anderson PAW, Rogers MC, Canet RV jr., Jarmakani JMM, Jewett PH, Spach MS (1972) Reversible complete heart block following cardiac surgery. Circulation 46: 514–521PubMedCrossRefGoogle Scholar
  3. 3.
    Anderson RH, Lenox CC, Zuberbuhler JR (1983) Mechanisms of closure of perimembranous ventricular septal defect. Am J Cardiol 52: 341–345PubMedCrossRefGoogle Scholar
  4. 4.
    Arciniegas E, Farooki ZQ, Hakimi M, Perry BL, Green EW (1980) Surgical closure of ventricular septal defect during the first twelve months of life. J Thorac Cardio-vasc Surg 80: 921–928Google Scholar
  5. 5.
    Barratt-Boyes BG, Neutze JM, Seelye ER, Simpson M (1972) Complete Correction of cardiovascular malformations in the first year of life. Prog Cardiovasc Dis 15: 229–253PubMedCrossRefGoogle Scholar
  6. 6.
    Barratt-Boyes BG, Neutze JM, Clarkson PM, Shardey GC, Brandt PWT (1976) Repair of ventricular septal defect in the first two years of life using profound hypothermia-circulatory arrest techniques. Ann Surg 184: 376–390PubMedCrossRefGoogle Scholar
  7. 7.
    Becker AE, Anderson RH (1982) Cardiac pathology. Churchill Livingstone, EdinburghGoogle Scholar
  8. 8.
    Becu LM, Fontana RS, DuShane JM, Kirklin JW, Bur-chell HB, Edwards JE (1956) Anatomic and pathologic studies in ventricular septal defect. Circulation 14: 349–364PubMedCrossRefGoogle Scholar
  9. 9.
    Bekir J (1970) Die Auswirkung der Vorhofinzision auf die Häufigkeit der postoperativen Herzrhythmusstörungen beim Verschluß des Vorhofseptumdefektes. Thoraxchirurgie 19: 154–164Google Scholar
  10. 10.
    Björk VO (1964) The transatrial approach to ventricular septal defect. J Thorac Cardiovasc Surg 47: 178–185Google Scholar
  11. 11.
    Blackstone EH, Kirklin JW, Bradley EL, DuShane JW, Appelbaum A (1976) Optimal age and results in repair of large ventricular septal defects. J Thorac Cardiovasc Surg 72: 661–679PubMedGoogle Scholar
  12. 12.
    Brunner L, Heisig B, De Vivie R et al. (1972) Über den Einfluß des pulmonalen Hochdrucks auf die Ergebnisse des operativen Verschlusses von Ventrikelseptumde-fekten. Thoraxchirurgie 20: 11–25Google Scholar
  13. 13.
    Ching E, DuShane JW, McGoon DC, Danielson GK (1971) Total correction of ventricular septal defect in infancy using extracorporeal circulation. Ann Thorac Surg 12: 1–10PubMedCrossRefGoogle Scholar
  14. 14.
    Coleman EN, Reid JM, Inall JA, Stevenson JG (1968) Ventricular septal defect repair in childhood. Br Heart J 30: 845–849PubMedCrossRefGoogle Scholar
  15. 15.
    Coleman EN, Reid JM, Barclay RS, Stevenson JG (1972) Ventricular septal defect repair after pulmonary artery banding. Br Heart J 34: 134–138PubMedCrossRefGoogle Scholar
  16. 16.
    Cooley DA, Halmann GL (1964) Cardiovascular surgery during the first year of life. Am J Surg 107: 474–480PubMedCrossRefGoogle Scholar
  17. 17.
    Daicoff GR, Miller RH (1970) Congestive heart failure in infancy treated by early repair of YSD. Circulation 41 [Suppl II]: 110–115Google Scholar
  18. 18.
    De Vivie R, Brunner L, Dehme N, Heisig B, Rastan H (1973) Rezidive nach operativem Verschluß von Ventri-kelseptumdefekten. Thoraxchirurgie 21: 50–55Google Scholar
  19. 19.
    Doty DB (1985) Cardiac surgery. Year Book Medical, ChicagoGoogle Scholar
  20. 20.
    Fisher RD, Brawley RK, Neill CA, Donahoo JS, Haller JA, Rowe RD, Gott VL (1973) Severe triscuspid regurgitation after repair of ventricular septal defect. J Tho-rac Cardiovasc Surg 65: 702–707Google Scholar
  21. 21.
    Galioto FM, Cooley DA, El-Said G, Mullins CE, San-diford FM (1973) Closure of ventricular septal defect through the aortic valve. Chest 64: 683–686PubMedCrossRefGoogle Scholar
  22. 22.
    Gerbode F, Aberg THJ (1968) Surgical anatomy of the heart. Modern Trends in Cardiac Surgery 2: 122–140Google Scholar
  23. 23.
    Griffiths SP, Turi GK, Ellis K et al. (1981) Muscular ventricular septal defects repaired with left ventriculotomy. Am J Cardiol 48: 877–886PubMedCrossRefGoogle Scholar
  24. 24.
    Henry J, Kaplan S, Helmsworth JA, Schreiber JT (1973) Management of infants with large ventricular septal defects. Ann Thorac Surg 15: 109–119PubMedCrossRefGoogle Scholar
  25. 25.
    Hoffman JIE, Rudolph AM (1965) The natural history of ventricular septal defects in infancy. Am J Cardiol 16: 634–653PubMedCrossRefGoogle Scholar
  26. 26.
    Hoffman JIE (1968) Natural history of congential heart disease. Problems in its assessment with special reference to ventricular septal defects. Circulation 37: 97–125PubMedCrossRefGoogle Scholar
  27. 27.
    Hudson REB (1967) Surgical pathology of the conducting system of the heart. Br Heart J 29: 646–670PubMedCrossRefGoogle Scholar
  28. 28.
    Hudspeth AS, Cordell AR, Meredith JH, Johnston FR (1962) An improved transatrial approach to the closure of ventricular septal defects. J Thorac Cardiovasc Surg 43: 157–165PubMedGoogle Scholar
  29. 29.
    Idriss FS, Nikaidoh H, Paul MH, Blumenschein SD, Riker WL (1971) Early repair of ventricular septal defect in infants and young children. Arch Surg 103: 265–271PubMedCrossRefGoogle Scholar
  30. 30.
    Kawashima Y, Fujita T, Mori T, Ihara K, Manabe H (1977) Trans-pulmonary arterial closure of ventricular septal defect. J Thorac Cardiovasc Surg 74: 191 – 194Google Scholar
  31. 31.
    Keith JD, Rose V, Collind G, Kidd BSL (1971) Ventricular septal defect: Incidence, morbidity and mortality in various age groups. Br Heart J 33: [Suppl] 81–87PubMedCrossRefGoogle Scholar
  32. 32.
    Kirklin JW, Harshbarger HG, Donald DE, Edwards JE (1957) Surgical correction of ventricular septal defect: anatomic and technical considerations. J Thorac Cardiovasc Surg 33: 45–59Google Scholar
  33. 33.
    Kirklin JW, McGoon DC (1958) Surgical technique for repair of high ventricular septal defects. J Thorac Cardiovasc Surg 35: 584–590Google Scholar
  34. 34.
    Lev M, Fell EH, Arcilla R, Weinberg MH (1964) Surgical injury to the conduction system in ventricular septal defect. Am J Cardiol 14: 464–476PubMedCrossRefGoogle Scholar
  35. 35.
    Lillehei CW, Cohen M, Warden HE, Ziegler NR, Varco RL (1955) The results of direct vision closure of ventricular septal defects in eight patients by means of controlled cross circulation. Surg Gynecol Obstet 101: 447–466Google Scholar
  36. 36.
    Lincoln C, Jamieson S, Joseph M, Shinebourne E, Anderson RH (1977) Transatrial repair of ventricular septal defects with reference to their anatomic classification. J Thorac Cardiovasc Surg 74: 183–189PubMedGoogle Scholar
  37. 37.
    Milo S, Ho SJ, Wikinson JL, Anderson RH (1980) Surgical anatomy and atrioventricular conduction tissues of hearts with isolated ventricular septal defects. J Thorac Cardiovasc Surg 79: 244–255PubMedGoogle Scholar
  38. 38.
    Mitchell SC, Korones SB, Berendes HW (1971) Congenital heart disease in 56109 births. Circulation 43: 323–332PubMedCrossRefGoogle Scholar
  39. 39.
    Muller WH jr, Dammann JF jr (1952) The treatment of certain congenital malformations of the heart by the creation of pulmonic stenosis to reduce pulonary hypertension and excessive pulmonary blood flow. Surg Gynecol Obstet 95: 213–219PubMedGoogle Scholar
  40. 40.
    Mustard WT, Bedard P, Trusler GA (1970) Cardiovascular surgery in the first year of life. J Thorac Cardiovasc Surg 59: 761–767PubMedGoogle Scholar
  41. 41.
    Reichart B, Klinner W, Sebening F, Bühlmeyer K (1973) Die zweiseitige chirurgische Behandlung des Ventrikelseptumdefektes. Bericht über 15 Fälle. Thoraxchirurgie 21: 16–26Google Scholar
  42. 42.
    Rein JG, Freed MD, Norwood WI, Casteneda AR (1977) Early and late results of closure of ventricular septal defect in infancy. Ann Thorax Surg 24: 19–27CrossRefGoogle Scholar
  43. 43.
    Satter P, Bircks W (1964) Der transatriale Zugang zum Verschluß des Ventrikelseptumdefektes. Langenbecks Arch Chir 308: 646–651PubMedCrossRefGoogle Scholar
  44. 44.
    Singh AK, De Levai MR, Stark J (1977) Left ventriculotomy for closure of muscular ventricular septal defects. Ann Surg 186: 577–580PubMedCrossRefGoogle Scholar
  45. 45.
    Skow JR, Mulder DG (1974) Atrial approach for repair of ventricular septal defect in corrected transposition. J Thorac Cardiovasc Surg 67: 426–429PubMedGoogle Scholar
  46. 46.
    Soto B, Becker AE, Moulaert AJ, Lie JT, Anderson RH (1980) Classification of ventricular septal defects. Brit Heart J 43: 332–342PubMedCrossRefGoogle Scholar
  47. 47.
    Stark J, Tynan M, Aberdeen E, Waterston DJ, Bonhan-Carter RE, Graham RG (1970) Repair of intracardiac defects after previous constiction of the pulmonary artery. Surgery 67: 536–543Google Scholar
  48. 48.
    Stirling GR, Stanley PH, Lillehei CW(1957) The effects of cardiac bypass and ventriculotomy upon right ventricle function. Surg Forum 8: 433–438Google Scholar
  49. 49.
    Titus JL (1973) Normal anatomy of the human cardiac conduction system. Mayo Clin Proc 48: 24–30PubMedGoogle Scholar
  50. 50.
    Van Praagh R, McNamara J J (1968) Anatomic types of ventricular septal defect with aortic insufficiency. Am Heart J 75: 604–619PubMedCrossRefGoogle Scholar
  51. 51.
    Wagner RB, Ankeney JL, Liebman J (1970) Correlation of mean pulmonary arterial pressure with results of surgery for nonrestrictive ventricular septal defects. J Thorac Cardiovasc Surg 60: 510–515PubMedGoogle Scholar
  52. 52.
    Yokoyama M, Takao A, Sakakibara S (1970) Natural history and surgical indications of ventricular septal defect. Am Heart J 80: 597–605PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • C. Huth
  • H.-E. Hoffmeister

There are no affiliations available

Personalised recommendations