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Background: Ventricular septal deformity (VSD) and Atrial septal deformity (ASD) are the most common congenital heart disease (CHD). This study intended to help improving morbidity and mortality of pediatrics patient with Ventricular septal defect and ASDs, through achieving the following objectives; assessment the role of diameter of defect, child age, measurement of serum l.carnitine and phospholipids in early spontaneous closure of atrial septal defects and ventricular septal defects . Patients and Methods: This was a cohort study was carried out at Pediatric Cardiology Unit of Zagazig University hospitals during the period from October 2019 to October 2020 Included 30 children up to 2 years of age were following for ASD or VSD. The patients were categorized into 2 groups: Group I; comprised 20 patients with ASD. Group II; comprised 10 patients with VSD were observed for 12 months with successive 2-dimensional echocardiography. All patients were subjected to full history and examination with special focus on cardiac manifestations, follow up echocardiography at 3 and 6 months viewing extent of the deformities which compared to preceding echocardiographic reports. Laboratory investigations was done with detection of Lcarnitine and phospholipids levels. Results: There was statistically significant higher total phospholipid among ASD patients with natural closure than regression to ≤ 3 mm and than residual >3 mm (p-value = 0.001) with no statistically significant difference regarding L. Carnitine (p-value = 0.1). There was statistically significant higher L. Carnitine among th e VSD patients with regression to ≤ 3 mm than residual >3 mm (p-value =0.01) with no statistically significant difference regarding total phospholipid (p-value =0.1). Age at diagnosis, defect size, total phospholipids and L-Carnitine were the statistically significant predictor factors for spontaneous closure of ASD and VSD among the studied group, Conclusion: Age at diagnosis, defect size, total phospholipids and L-Carnitine were the statistically significant predictor factors for spontaneous closure of ASD and VSD among the studied group.

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