Ventricular septal defects (VSD) are the most common cardiac congenital heart defect (about 1/3 of patients with congenital heart disease). VSD management is related to hemodynamics and anatomical localization and the occurrence of complications. Small perimembranous VSD without pulmonary hypertension and without significant left to right shunting are tolerated, whereas large VSD with pulmonary hypertension require early surgical management in the first months of life. The management uncertainties concern the medium-sized perimembranous VSD causing a significant left-right shunt but without pulmonary hypertension, which are of variable treatment (surgical correction, percutaneous treatment, medical or abstention). There are no recommendations or consensus on the preferred indication of a therapeutic attitude. The Pediatric and Congenital Cardiology Subsidiary, within the French Society of Cardiology, set up an observatory of perimembranous VSD with significant shunting, without pulmonary hypertension the objectives of this study are: * To study the incidence of cardiovascular events in perimembranous VSD and search for predictive anatomical markers of events. * To study the evolution of echocardiographic and functional data of patients having percutaneous or surgical closure compared to patient managed medically. This observatory will provide a better understanding of the therapeutic algorithm in the management of VSD with pulmonary overload without pulmonary hypertension.
Study Type
OBSERVATIONAL
Enrollment
218
Centre Chirurgical Marie Lannelongue
Le Plessis-Robinson, France
Hopital Europeen Georges Pompidou
Paris, France
Gh Sud Hopital Haut Leveque
Pessac, France
Chu Toulouse - Hopital Des Enfants
Toulouse, France
Incidence of Cardiovascular Events at 5 Years of Perimembranous VSD with pulmonary overload
The main criterion "cardiovascular event" is a composite criterion. At least 1 of the following criteria is required for the primary criterion to be met: * endocarditis, * aortic stenosis (mean gradient\> 20 mmHg) * aortic insufficiency * left ventricular outflow tract stenosis (mean gradient\> 20 mmHg) * tricuspid insufficiency ≥2 * surgery or cardiac interventional catheterization for an abnormality in relation to the VSD (other than simple closing) * persistent supraventricular arrhythmias, sustained ventricular arrhythmia, * stroke * Complete atrioventricular block (AVB) * Pulmonary Arterial Hypertension (PAH) * heart failure * cardiovascular deaths, * severe haemolysis (= requiring transfusion or interventional catheterization or surgical).
Time frame: 5 years of follow-up
Anatomical predictive elements of events at 5 years of follow-up.
The event criterion meets the same definition as the primary judgment criterion. The association between anatomical elements (size of the VSD, presence of aneurysm, diameter and depth of the aneurysm, septo-aortic angulation) and cardiovascular events will be studied.
Time frame: 5 years of follow-up
Evolution of the left ventricular end diastolic diameter z-score one year after VSD closure
Evolution of the left ventricular end diastolic diameter z-score one year after VSD closure
Time frame: 1 year of follow-up
Incidence of cardiovascular events of "high-flow" VSDs according to the different therapeutic options at 5 years of follow-up
Incidence of cardiovascular events of "high-flow" VSDs according to the different therapeutic options (medical - percutaneous closure - surgical closure) at 5 years of follow-up. The event criterion meets the same definition as the primary judgment criterion.
Time frame: 5 years of follow-up
Incidence of cardiovascular events of "high-flow" VSDs according to the different therapeutic options at 10 years of follow-up.
Incidence of cardiovascular events of "high-flow" VSDs according to the different therapeutic options (medical - percutaneous closure - surgical closure) at 10 years of follow-up. The event criterion meets the same definition as the primary judgment criterion.
Time frame: 10 years of follow-up
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