Andersons pediatric cardiology 858
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technologyofferedintraoperativevisualization
ofventriculardefectstogeneratea“virtual
senseofdepth.”Fromleftventricularenface
projections,theposition,size,andshapeofthe
defectscouldaccuratelybedeterminedtopermit
quantitativeexaminationofdynamics.Thisstudy
underscoresthisasapotentiallyvaluable
clinicaltooltoprovideimagingforsurgicaland
catheter-basedinterventions.
BargeronLM,ElliottLP,SotoB,BreamPR,Curry
GC.Axialcineangiographyincongenitalheart
disease.SectionI.Concept,technicaland
anatomicalconsiderations.Circulation.
1977;56:1075–1083.
ElliottLP,BargeronLM,BreamPR,SotoB,Curry
GC.Atrialcineangiographyincongenitalheart
disease.SectionII.Specificlesions.Circulation.
1977;56:1084–1093.
SantamariaH,SotoB,CeballosR,etal.
Angiographicdifferentiationoftypesof
ventricularseptaldefects.AmJRadiol.
1983;141:273–281.
Thesestudiesrepresenta“mustread”forany
pediatriccardiologistinterestedintheanatomy
ofthecongenitallymalformedheart.Theysetthe
stageforthedetailedunderstanding,definition,
andcharacterizationofventricularseptal
defects.
KiddL,DriscollDJ,GersonyWM,etal.Second
naturalhistorystudyofcongenitalheartdefects.
Resultsoftreatmentofpatientswithventricular
septaldefect.Supplement:reportfromthe
secondjointstudyonthenaturalhistoryof
congenitalheartdefects(NHS-2).Circulation.
1993;87:38–51.
TheNaturalHistoryStudiesofCongenitalHeart
Defectswerethefirstsignificantmulticentric
investigationsofoutcomesforavarietyof
congenitalcardiaclesionscommonlyseenin
practice.Thesestudiessetthe“goalposts”for
thedefinitionofseverityandtheimpactatthe
timeofmedicalandsurgicaltherapies.They
becameandtoalargeextentremaineventoday
thebasisforthedecisionswemakeaspediatric
cardiologists.
GersonyWM.Naturalhistoryanddecision-making
inpatientswithventricularseptaldefects.Prog
PediatrCardiol.2001;14:125–132.
WeltonGersonyisanexperiencedpediatric
cardiologistwhohascontributedsignificantlyto
ourunderstandingoftheclinicalcourseofmany
congenitalcardiaclesions.Inthispaper,he
providesasensibleapproachtomanagement
basedondatafromthepreviousnaturalhistory
studies.Thesectionpresentingvariousquestions
inmanagementandprovidingtheiranswersis
particularlyusefulfortheyoungcardiologist.
YeagerSB,FreedMD,KeaneJF,NorwoodWI,
CastanedaAR.Primarysurgicalclosureof
ventricularseptaldefectinthefirstyearoflife:
resultsin128infants.JAmCollCardiol.
1984;3:1269–1276.
Thisexcellentstudyreviewstheoutcomesof
primarysurgicalmanagementoftheinfantwith
aventricularseptaldefect.
VanHareGF,SofferLJ,SivakoffMC,LiebmanJ.
Twenty-five-yearexperiencewithventricular
septaldefectininfantsandchildren.AmHeartJ.
1987;114:606–614.
GabrielHM,HegerM,InnerhoferP,etal.Longtermoutcomeofpatientswithventricularseptal
defectconsiderednottorequiresurgicalclosure
duringchildhood.JAmCollCardiol.
2002;39:1066–1071.
NeumayerU,StoneS,SomervilleJ.Small
ventricularseptaldefectsinadults.EurHeartJ.
1998;19:1573–1582.
MeijboomF,SzatmariA,UtensE,etal.Long-term
follow-upaftersurgicalclosureofventricular
septaldefectininfancyandchildhood.JAm
CollCardiol.1994;24:1358–1364.
