Clinical course in adults with ventricular septal defect

Area of Science:

• Cardiology
• Pediatric Cardiology
• Adult Congenital Heart Disease

Background:

• Ventricular septal defects (VSDs) are common congenital heart abnormalities.
• Understanding the natural history and treatment outcomes in adults with VSDs is crucial.
• Pulmonary vascular disease and Eisenmenger's syndrome represent severe VSD complications.

Purpose of the Study:

• To evaluate the clinical course and outcomes of adult patients with VSDs.
• To compare medical versus surgical management strategies for VSDs in adults.
• To assess the impact of VSDs on pulmonary vascular disease and Eisenmenger's syndrome.

Main Methods:

• Retrospective analysis of adult patients from a Natural History Study.
• Categorization based on VSD size (small vs. large) and presence of pulmonary vascular disease.
• Review of medical records, including catheterization data and surgical outcomes.

Main Results:

• Adults with small VSDs had favorable outcomes, with many achieving complete closure or stable shunts.
• Surgical intervention for small VSDs resulted in complete closure in most cases.
• Patients with large VSDs and moderate pulmonary vascular disease showed varied outcomes with surgery, including mortality.
• Eisenmenger's syndrome carried a high mortality rate, even with surgical intervention.

Conclusions:

• Small VSDs in adults are generally well-managed with favorable prognoses.
• Surgical management of VSDs in adults can be effective but carries risks, especially with significant pulmonary vascular disease.
• Eisenmenger's syndrome remains a severe complication with limited treatment success.