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European Heart Journal 1992 13(5):642-645;
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Doppler echocardiographic observations of diastolic trans-septal flow through small ventricular septal defects

S. A. WEBBER, G. G. S. SANDOR and M. W. H. PATTERSON

Division of Cardiology, Department of Paediatrics, British Columbia Children's Hospital, University of British Columbia Vancouver, Canada

Received 8 February 1991; revised 25 July 1991; .

Correspondence: Dr S. A. Webber, Division of Cardiology, Children's Hospital of Pittsburgh, 3705 5th Avenue at DeSoto Street, Pittsburgh, PA, U.S.A.

Abstract

Turbulent left-to-right trans-septal diastolic blood flow with apeak velocity greater than 0.5 m.s–1 was detected by pulsed Doppler echocardiography in 10 out of 204 (4.9%) children with isolated small ventricular septal defects. For children older than 10 years, it was observed in over a quarter of cases (27%). Peak diastolic velocities ranged from 0.6–1.9 m.s–1 (mean 1.2 m.s–1) and in all patients the duration of diastolic flow exceeded that of the systolic trans-septal jet. Three different patterns of diastolic flow were observed and in eight cases pre-systolic acceleration was present. Turbulent diastolic flow across small ventricular septal defects is a common finding in older children and should not be confused with other causes of disturbed diastolic flow within the right ventricle.

Key Words: Doppler echocardiography • ventricular septal defect • diastolic flow


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