The Natural History of Ventricular Septal Defects in Infancy

Hoffiman, J. I. E.; Rudolph, Arnold J.

doi:10.1097/00004424-196609000-00012

Cited by 31 publications

(43 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…No infective endocarditis was observed. It is concluded that patients with VSD should be followed closely through adolescence, because the diameter of the defect, as well as left-to-right shunting, can decrease, and it is concluded that the spontaneous closure of the defect is to be expected in a considerable 23%, and aortic prolapse or mild regurgitation may develop in approximately 10%.The most important period in the natural history of isolated ventricular septal defect (VSD) is the first few years of life [1,2,7,17,19,24,30], because treatment and surgical correction decisions are vital in this period. Those who reach adulthood are the patients in whom the VSD has not closed spontaneously or surgically and those selected few with Eisenmenger syndrome in whom operation is contraindicated [4-6, 8, 11, 16, 23, 34, 37].…”

mentioning

confidence: 99%

“…The most important period in the natural history of isolated ventricular septal defect (VSD) is the first few years of life [1,2,7,17,19,24,30], because treatment and surgical correction decisions are vital in this period. Those who reach adulthood are the patients in whom the VSD has not closed spontaneously or surgically and those selected few with Eisenmenger syndrome in whom operation is contraindicated [4-6, 8, 11, 16, 23, 34, 37].…”

mentioning

confidence: 99%

See 1 more Smart Citation

The Natural Course of Isolated Ventricular Septal Defect During Adolescence

et al. 1998

View full text Add to dashboard Cite

Serial changes in patients with isolated VSD during adolescence have not previously been investigated. Hemodynamic status, diameter of the defect, and growth were studied yearly in 106 children with VSD. The mean duration of the follow-up was 13.16 years and ranged in 80% of subjects from 7 to 19 years (1395 patients years). The mean ages at pre- and postpuberty were 8.62 and 16.67, respectively. The presented longitudinal study, in which losses due to death and operation were minimal (4%), ideally reflected the natural history of VSD. Although weight showed retardation during prepuberty, this lag was caught up by the end of adolescence. Stature showed no retardation in pre- and postpuberty. Cardiothoracic ratio decreased significantly from a mean of 0.48 to 0.44 and showed normal variation. Although the mean defect diameter at prepuberty was 5.33 mm, this decreased to 2.7 postpubertally. The individual decrease (1.7 +/- 2.34 mm) was significant (t = 5.349, p < 1/10(5)). The defect closed spontaneously in 24 (22.6%). In the 75 patients without pulmonary hypertension and with mild left-to-right shunting, 52 remained in the same class and spontaneous closure was observed in 23. In the 24 patients with moderate to severe left-to-right shunt, this decreased in 23 and only one remained stable. The 2 patients (1.9%) with Eisenmenger syndrome remained stable and 1 died. Aortic regurgitation developed in 10 patients (9.4%); however, this was of mild degree in most of them. No infective endocarditis was observed. It is concluded that patients with VSD should be followed closely through adolescence, because the diameter of the defect, as well as left-to-right shunting, can decrease, and it is concluded that the spontaneous closure of the defect is to be expected in a considerable 23%, and aortic prolapse or mild regurgitation may develop in approximately 10%.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

The Natural Course of Isolated Ventricular Septal Defect During Adolescence

et al. 1998

View full text Add to dashboard Cite

show abstract

“…Serial hemodynamic studies, however, were selectively done in patients with only moderate or large defects. Others presenting serial catheterization data starting from those aged less than 1 year, in selected patients with large VSD [6,13,16,18,20,46], focused on PVR without mentioning the PAP. An increase in PVR was observed in <10% [16] and development of fixed PVR increase was between 0.7% and 5%, all having large defects.…”

Section: Discussionmentioning

confidence: 99%

“…Others presenting serial catheterization data starting from those aged less than 1 year, in selected patients with large VSD [6,13,16,18,20,46], focused on PVR without mentioning the PAP. An increase in PVR was observed in <10% [16] and development of fixed PVR increase was between 0.7% and 5%, all having large defects. Others included severe patients after infancy, many of which were candidates for surgical closure [21,33,40,47], or exclusively selected patients with pulmonary hypertension [1,12].…”

Section: Discussionmentioning

confidence: 99%

Regression of Right Ventricular Pressure in Ventricular Septal Defect in Infancy: A Longitudinal Color-Flow Doppler Echocardiographic Study

et al. 1999

View full text Add to dashboard Cite

To determine the course of right ventricular pressure (RVP) in patients with isolated ventricular septal defect (VSD) and factors influencing it, unselected 148 infants were followed-up longitudinally with color-Doppler echocardiography from a median age of 1 month for 201 patient-years. The patients were divided into three groups by absolute echographic size of VSD: group I, 4 to 7 mm. Sixty percent belonged to group I. Muscular defects dominated in group I, perimembranous defects dominated in group II, and those with outlet extensions dominated in group III. Peak systolic RVP was obtained by Doppler-estimated difference between systolic brachial artery and peak gradient across the VSD. Initial RVP ranged between 15 and 95 mmHg and increased in parallel to the size of defect. According to the regression equations RVP decreased in general by 0.17 mmHg per month. This correlated significantly with the size of the defect. In group I, the rate of decrease was very fast and is best expressed by a log function of time (r = -0.67, r(2) = 0.45). In groups II and III the rate of decrease was less steep and had a greater variability. RVP normalized in 100% in those of group I and in 90% of group II, at median ages of 0.17 and 0.33 years, respectively. Median Q(p):Q(s) values were 1.5, 2.2, and 3.0 in groups I-III, respectively. The outcome depended on the size of VSD. Spontaneous closure was observed in 51% of group I, 10% of group II, and none of group III. The rate was higher in muscular defects. Congestive heart failure was present in 53% and 100% in groups II and III, respectively. Death rate was 2.03%, all in patients with large defects. It is concluded that the temporal course of RVP with time can be estimated fairly well by the regression equation presented in relation to the initial size of the VSD.

show abstract

“…The incidence rate of VSDs among live births is 1.5-3.5 per 1,000 term infants and 4.5-7.0 per 1,000 premature infants [2].…”

Section: Introductionmentioning

confidence: 99%

Cardiac multidetector computed tomography (MDCT) of spontaneously closed ventricular septal defect

et al. 2009

View full text Add to dashboard Cite

Our study shows that the incidence of spontaneous closure of muscular VSD with central septum location is probably higher than expected. Thus, some patients initially diagnosed with ventricular diverticula with an apical and marginal septum location may actually have spontaneously closed muscular VSD. This finding may affect previously reported rates of both ventricular diverticula and spontaneous closure of muscular VSD.

show abstract

The Natural History of Ventricular Septal Defects in Infancy

Cited by 31 publications

References 0 publications

The Natural Course of Isolated Ventricular Septal Defect During Adolescence

The Natural Course of Isolated Ventricular Septal Defect During Adolescence

Regression of Right Ventricular Pressure in Ventricular Septal Defect in Infancy: A Longitudinal Color-Flow Doppler Echocardiographic Study

Cardiac multidetector computed tomography (MDCT) of spontaneously closed ventricular septal defect

Contact Info

Product

Resources

About