심실중격결손증 환아에서 비침투적 방법을 이용한 수술적응기준에 관한 고찰

Abstract

In selected cases, early corrective surgery is indicated in the management of infants with moderate or large ventricular septal defects. The risks of any surgical procedure in infancy are acknowledged to be great and should be avoided if possible. However, these surgical risks are justified when the patients have intractable congestive heart failure, marked growth retardation, recurrent prolonged lower respiratory infections and severe pulmonary hypertension. Cardiac catheterization should be included for diagnosis of congenital heart diseases before surgery. However, the risk of such study, even in experienced laboratories, is life threatening among the small, severely ill infants. Thirty-six infants and children under the age of 2 years underwent patch closure of a ventricular septal defect without cardiac catheterization and revealed good results. All patients were selected under the criteria of operation without cardiac catheterization. We concluded that two dimensional echocardiography provided a reliable and promising non-invasive method of identifying the ventricular septal defect in high risk small, severely ill patients.