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Small ventricular septal defect: long-term expectant clinical management.
1conatik@incor.usp.br
Arquivos Brasileiros De Cardiologia
|July 25, 2009
Summary
Small ventricular septal defects (VSD) typically show favorable long-term outcomes. Most small VSDs do not require surgery, but careful monitoring and antibiotic prophylaxis are advised.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Echocardiography
Background:
- Small ventricular septal defects (VSD) often exhibit a positive clinical trajectory.
- Long-term follow-up data is crucial for understanding VSD evolution.
Purpose of the Study:
- To assess the long-term clinical course of small VSDs.
- To inform decisions regarding surgical intervention versus expectant management for small VSDs.
Main Methods:
- Evaluation of 187 small VSD cases (diameter < 3 mm) with 155 undergoing long-term follow-up.
- Categorization into groups based on spontaneous closure, size persistence, or size decrease.
- Analysis of murmur manifestation timing and clinical complications.
Main Results:
- The majority of murmurs manifested within the first month of life.
- Spontaneous VSD closure occurred in 75% within the first year, with some persisting up to 40 years.
- No clinical complications were reported in the studied cohort.
Conclusions:
- Favorable long-term evolution of small VSDs suggests non-surgical management is often appropriate.
- Continued vigilance regarding antibiotic prophylaxis is warranted for patients with VSD.
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