Influence of left ventricular cavity size on interventricular shunt timing and outcome in neonates with coarctation of the aorta and ventricular septal defect

Currently, coarctation of the aorta can be repaired with low morbidity and mortality in neonates.(1,2) Approximately 40% of patients with coarctation have an associated ventricular septal defect (VSD) that typically shunts from left-to-right during systole, influencing hemodynamics, clinical presentation, and treatment. Neonates with coarctation and VSD usually have pulmonary hypertension(3-8) and decreased left ventricular (LV) distensibility(3) that may influence the amount and direction of shunting at the ventricular level. This study examines VSD shunting patterns, identifies anatomic features associated with each pattern, and evaluates the influence of these features on outcome of patients with coarctation and VSD.