Defect of an interventricular partition

Description:

Defect of an interventricular partition (DMZhP) - the inborn heart disease which is characterized by existence of defect between the right and left ventricles of heart.
Defect of an interventricular partition (DMZhP) - meets most often, and both in the isolated look, and as a part of many other heart diseases. Among VPS the frequency of this defect varies from 27,7 to 42%. Equally often occurs both at boys, and at girls. There are data on autosomal and dominant and recessive modes of inheritance. In 3,3% of cases with DMZhP also find this defect in direct relatives of patients.
In an interventricular partition allocate 3 departments: an upper part – hymenoid, adjoins to the central fibrous body, a middle part – muscular, and lower – trabecular. According to these departments call also defects of an interventricular partition, however most of them have perimembranozny localization (to 80%). 20% fall to the share of muscular DMZhP.

By the sizes defects subdivide on big, average and small. For the correct assessment of size of defect its size should be compared to diameter of an aorta. The minor defects of 1-2 mm in size located in a muscular part of an interventricular partition are called Tolochinov-Roget's disease. Owing to a good auskultativny picture and lack of hemodynamic disturbances expression is relevant to their characteristic: "much ado about nothing". Separately mark out multiple big defects of an interventricular partition, as "Swiss cheese", having adverse predictive value.

Symptoms of Defect of an interventricular partition:

The clinical picture at DMZhP consists in a symptom complex of the heart failure developing, as a rule, on 1-3 months of life (depending on the extent of defect).  Except symptoms of heart failure of DMZhP can demonstrate early and heavy pneumonia. At survey of the child it is possible to reveal tachycardia and short wind, expansion of limits of relative cordial dullness, shift of an apical beat down and to the left. In some cases the symptom of "cat's purring" is defined. Systolic noise, as a rule, intensive, is dried up over all area of heart, well carried out on the right side of a thorax and on a back with the maximum intensity to the IV mezhreberye to the left of a breast. At a palpation of a stomach the hepatomegalia and a splenomegaly is defined. Changes of a peripheral pulsation are not characteristic. At children with DMZhP the hypotrophy usually quickly develops.

Reasons of Defect of an interventricular partition:

Defect of an interventricular partition arises as a malformation in an embryogenesis, at laying of bodies.

Treatment of Defect of an interventricular partition:

Treatment of this defect means conservative therapy of heart failure and surgical correction of heart disease. Conservative treatment consists of drugs of inotropic support (sympathomimetics, cardiac glycosides), diuretic drugs, kardiotrofik. In cases of high pulmonary hypertensia inhibitors of an angiotensin-converting enzyme – капотен or captopril are appointed.

Operative measures are subdivided into palliative operations (in case of DMZhP – operation of narrowing of a pulmonary artery on Müller) and a definitive repair of defect – plastics of defect of an interventricular partition by a patch from pericardium leaves in the conditions of artificial circulation, a cardioplegia and a hypothermia.