RT Book, Section A1 Doherty, Gerard M. SR Print(0) ID 58105489 T1 Ventricular Septal Defect (VSD), Congenital T2 Quick Answers Surgery YR 2010 FD 2010 PB The McGraw-Hill Companies PP New York, NY SN LK accesssurgery.mhmedical.com/content.aspx?aid=58105489 RD 2024/03/29 AB • A congenital heart lesion that increases pulmonary arterial blood flow• Results in left-to-right shunt, results in lung infection, pulmonary vascular congestion, pulmonary artery (PA) hypertension, right heart failure, pulmonary vasoconstriction, pulmonary vascular obstructive disease• Eisenmenger syndrome: Increased pulmonary hypertension such that left-to-right shunt ceases and shunt becomes right-to-left, requiring heart-lung transplant• Inhaled nitric oxide, oxygen, or IV tolazoline reverses PA vasoconstriction• PA band is palliative and can reduce PA flow to alleviate RV failure and progression of pulmonary hypertension• Defects occur in 4 anatomic positions-Perimembranous septum (85%), anterior to crista supraventricularis, beneath leaflet of tricuspid valve, or muscular septum• Often associated with more complex defects: Truncus arteriosus, AV canal defect, tetralogy of Fallot, transposition of great arteries• Isolated perimembranous defects may have associated patent ductus arteriosus (PDA), aortic coarctation• Supracristal defects may have aortic regurgitation