THE VENTRICULAR SEPTAL DEFECT MEASURES 2MM WITH A LEFT TO RIGHT FLOW, THE JET APPEARS TO BE JUST BELOW THE LEVEL OF THE TRICUPID VALVE, SOME OF THE IMAGES SUGGEST THE FLOW MERGES WITH THE TRICUSPID VALVE, AND IT MAY BE A LEFT VENTRICULAR - RIGHT ATRIUM SHUNT. A PEAK GRADIENT OF 26 MM HG WAS OBTAINED. WHAT DOES THIS MEAN ?
For confirmation a transesophageal echocardiography (TEE) is helpful to determine whether there is a direct or indirect left ventricular-to-right atrial shunt (blood flow), and if there is tricuspid valve insufficiency, also, a TEE would be helpful to evaluate for repair.
The left ventricular-to-right atrial shunts can cause individuals to have significant symptoms that can be heart failure, exercise intolerance, etc. The defect is often away from the electrical impulse conduction so there is no arrhythmia and no significant valve disorder.
The chances of heart failure occuring in a 2MM VSD, which is quite small, would be very slim. Most small VSDs cause few if any symptoms, and most do not have to be repaired. They will close spontaneously, or remain open without complications. You don't mention how old the child is?
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