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Factors influencing the spontaneous closure of ventricular septal defect in infants

Yang Xu1, Jinxiang Liu1, Jinghua Wang1

  • 1Center of Pediatrics, Institute of Pediatrics, First Affiliated Bethune Hospital, Jilin University Changchun 130021, China.

International Journal of Clinical and Experimental Pathology
|July 21, 2015
PubMed

Insights

Certain infant and defect characteristics predict spontaneous closure of ventricular septal defects (VSD). Key predictors include defect size, cardiac chamber dimensions, and associated conditions like patent ductus arteriosus (PDA).

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease Research

Background:

  • Ventricular septal defects (VSD) are common congenital heart abnormalities.
  • Spontaneous closure of VSDs occurs in a significant proportion of infants, but predictors are not fully elucidated.

Purpose of the Study:

  • To prospectively identify maternal and infantile variables that predict spontaneous closure of VSD in infants.
  • To evaluate the clinical utility of specific parameters in predicting VSD resolution.

Main Methods:

  • A prospective cohort study followed infants diagnosed with VSD before six months of age for at least five years.
  • Demographic, clinical, maternal, and echocardiographic data were collected and analyzed for associations with spontaneous VSD closure.

Main Results:

  • Of 425 eligible infants, 93 (21.9%) experienced spontaneous VSD closure, with 78.5% closing before age three.
  • Independent predictors of closure included defect diameter (DVSD), DVSD/aortic root diameter ratio (DVSD/DAR), left atrium and ventricle sizes, pulmonary forward blood flow, infection scores, shunt ratio (Qp/Qs), VSD location, and comorbidities (PDA, membranous septal aneurysm).
  • Maternal factors during early pregnancy and Down syndrome did not significantly impact spontaneous closure rates.

Conclusions:

  • Specific echocardiographic and clinical factors are valuable independent predictors of spontaneous VSD closure in infants.
  • Parameters such as DVSD, DVSD/DAR, cardiac chamber dimensions, pulmonary blood flow, infection scores, Qp/Qs, VSD location, and comorbidities like PDA can guide clinical management and prognostication.
Abstract

Keywords:
Ventricular septal defectpredictive factorprognosisspontaneous closure

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