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Natural history of isolated ventricular septal defect in the first five years of life

A V Mehta, S Goenka, B Chidambaram

    Tennessee Medicine : Journal of the Tennessee Medical Association
    |February 7, 2001
    PubMed

    Insights

    Most isolated ventricular septal defects (VSD) close spontaneously by age five. Muscular VSDs have better outcomes than perimembranous VSDs, though some require long-term follow-up.

    Area of Science:

    • Pediatric Cardiology
    • Congenital Heart Disease Research
    • Echocardiography in Pediatric Cardiology

    Background:

    • Isolated ventricular septal defect (VSD) is the most common congenital heart defect.
    • VSD incidence, prevalence, and outcomes vary geographically.
    • Spontaneous VSD closure in children has been documented.

    Purpose of the Study:

    • To evaluate the natural history of isolated VSD in children during their first five years of life.
    • To assess VSD outcomes in the Northeast Tennessee and Southwest Virginia region.

    Main Methods:

    • Prospective study of 124 infants diagnosed with isolated VSD between December 1998 and October 1990.
    • VSD classification using 2D echocardiogram with color flow mapping (muscular, perimembranous, malalignment, subpulmonic).
    • Follow-up for at least five years, with cardiac catheterization and angiocardiography for 14 patients.

    Main Results:

    • Overall VSD spontaneous closure rates were 34% at one year and 67% at five years.
    • Muscular VSDs closed spontaneously at twice the rate of perimembranous VSDs.
    • Surgery was required for 25% of perimembranous VSDs and 4% of muscular VSDs by age five; 22% of children required follow-up beyond five years.

    Conclusions:

    • Muscular VSDs demonstrated better clinical outcomes compared to perimembranous VSDs.
    • Despite better outcomes, 17% of muscular VSDs remained open at age five, necessitating long-term follow-up.
    Abstract

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