The Natural History of Ventricular Septal Defects

Turner, Steven; Hunter, A S; Wyllie, Jonathan

doi:10.1203/00006450-199809000-00049

Cited by 10 publications

(31 citation statements)

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“…Types of VSD. Muscular VSD is believed to be more likely to close spontaneously than membranous VSD (14) or perimembranous VSD (15,16). It was reported that in 68 children with VSD, 69% (27 of 39) of muscular defects and 28.5% (8 of 28) of perimembranous defects closed spontaneously, indicating that the incidence was signifi cantly greater for muscular defects than for perimembranous defects (15).…”

Section: Incidence Of Spontaneous Vsd Closurementioning

confidence: 99%

A Review of Spontaneous Closure of Ventricular Septal Defect

Zhang¹,

Ko²,

Guileyardo³

et al. 2015

Baylor University Medical Center Proceedings

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516Ventricular septal defect (VSD) is the most common congenital heart malformation and can be detected during the prenatal and postnatal period, in childhood, and in adulthood. Spontaneous closure of VSD can be determined through a variety of methods-echocardiography, Doppler color flow imaging, angiography, auscultation, and cardiac catheterization-and can be proven by pathological evidence at necropsy. There are two major types of VSD, membranous and muscular, as well as the perimembranous variety, which comprises variable portions of the adjacent muscular septum but lacks the membranous septum. VSD appears either as an isolated cardiac defect without other abnormalities or with several complex malformations. It has long been recognized that VSD can close spontaneously, but the incidence of spontaneous VSD closure is still uncertain. Since necropsy study of the hearts with VSD has rarely been reported, information on morphological features of spontaneous VSD closure remains limited. In addition, the mechanisms for spontaneous VSD closure are not fully understood. Herein, we present a brief review of the incidence of spontaneous VSD closure, morphological characteristics of the closure, and the main mechanisms responsible for the closure. INCIDENCE OF SPONTANEOUS VSD CLOSURETh e incidence of spontaneous ventricular septal defect (VSD) closure varies greatly, depending on the age and gender of subjects at spontaneous closure, the size and site of the defect, the types of defect, as well as the population studied, methods employed, and length of follow-up period. Table 1 presents available data on the incidence of spontaneous VSD closure.Age and gender. Age has been found to have a significant infl uence on the incidence of spontaneous VSD closure, whereas gender seems less likely to aff ect the incidence. Although spontaneous VSD closure can occur at any agegestation, infancy, childhood, adolescence, and adulthood (1)-it occurs most commonly during the fi rst 6 months of life (2), during the fi rst year (3, 4), or soon after the fi rst year of life (5). Afterward, the occurrence of closure declines progressively and occurs less commonly after the age of 10 (5). It has been documented that the incidence of the close increases with age, from 24% at 18 months of age to 50% at 48 months and 75% at 120 months (6). However, in older children, at 3.5 years old, the incidence declines sharply to 44% and then rises to 66% at 7 years and 75% at 10.5 years (6). A similar trend has been found in other reports, which showed 57% (109/190) of cases closed before 3 years of age, 89% (169/190) closed before 8 years of age (7), and 4% to 10% closed after the age of 17 (8, 9). During adulthood, the incidence of spontaneous VSD closure remarkably declines. One study showed that of 188 adults with VSD, 19 patients' (10%) VSD closed spontaneously between the age of 17 and 45 years, and the incidence of closure was greater in the 17-to 24-year age group than the 25-to 34-year group, the 35-to 44-year group, and the ≥45-year group (8)...

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Section: Incidence Of Spontaneous Vsd Closurementioning

confidence: 99%

A Review of Spontaneous Closure of Ventricular Septal Defect

Zhang¹,

Ko²,

Guileyardo³

et al. 2015

Baylor University Medical Center Proceedings

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“…As previously described, 11 consultants in paediatrics were asked to refer all suspected cases during this period to the sole regional paediatric cardiac unit at Freeman Hospital. We have previously demonstrated no significant inter-observer variation of echo reporting regarding either the size or morphology of a ventricular septal defect.…”

Section: Subjectsmentioning

confidence: 99%

“…We have previously demonstrated no significant inter-observer variation of echo reporting regarding either the size or morphology of a ventricular septal defect. 11 For the period of the study, case notes were reviewed, taking note of sex; month of birth; gestation in weeks; age at presentation; presence of genetic syndromes; size and morphology of the defect at the time of diagnosis; presence of multiple defects; age at closure, if it occurred; method of closure, either spontaneous or surgical and, in the cases of patent defects, age when last seen.…”

Section: Subjectsmentioning

confidence: 99%

“…11 We concluded that it was morphology rather than size that predicted the natural history. In this study, we have extended our investigation to describe the natural history of isolated defects in children born between 1991 and 1993-Our aims were: to confirm our previous findings using a larger cohort; to determine predictors of spontaneous and surgical closure; to determine the incidence and importance of aortic regurgitation in perimembranous defects; and to determine the mode of spontaneous closure in perimembranous ventricular septal defects.…”

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confidence: 97%

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Closure of ventricular septal defects: a study of factors influencing spontaneous and surgical closure

2002

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The size and morphology of a ventricular septal defect are important determinants of spontaneous closure and to the need for surgical intervention. Early age at presentation, in contrast, is not predictive of the need for surgical intervention. In early childhood, there appears to be very little risk of endocarditis or aortic valvar prolapse. Neither screening of populations to identify ventricular septal defects, nor surgical closure of asymptomatic defects in childhood, are supported by our findings.

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“…Conclusão: Ressalvando-se o pequeno número de casos e o curto tempo de seguimento, o uso do dispositivo Nit-Occlud TM Lê VSD A s comunicações interventriculares são os defeitos cardíacos mais comuns na infância, correspondendo a aproximadamente 20% de todas as cardiopatias congênitas nessa faixa etária. Apresentam-se com grande número de variáveis anatômicas e diferente história natural 1 .…”

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