Sun et al reported indications for surgical closure of a perimembranous ventricular septal defect (VSD). The authors are from Shanghai Jiaotong University and Shanghai Children's Medical Center.
Patient selection: perimembranousventricular septal defect (PMVSD)
Measurement: pulmonary artery systolic pressure in mm Hg by echocardiography
Indications for surgical closure - one or more of the following:
(1) severe congestive heart failure AND PASP >= 60 mm Hg
(2) chronic cardiac insufficiency AND clinical problems for >= 6 months (poor feeding, tachypnea, poor weight gain, repeated pulmonary infection) AND continuous pulmonary hypertension (PASP > 36 and < 60 mm Hg)
(3) chronic cardiac insufficiency without pulmonary hypertension AND no significant change in defect size for >= 2 years AND patient school age
(4) associated complications resulting in one or more of the following:
(4a) obstruction of the left or right ventricle
(4b) moderate or severe aortic regurgitation
