Natural History of Ventricular Septal Defect: A Five Year Follow-up Study

Document Type

Article

Publication Date

10-1-1996

Description

Purpose: To study the natural history of Ventricular Septal Defect (VSD) in the North-east Tennessee area from birth to 5 years. Methods: Of approximately 22,000 live births in the region born between Dec 1986 and Nov 1990, all infants referred with a murmur were evaluated by the only pediatric cardiologist in this area. 124 infants were identified with VSD as the primary or isolated congenital heart lesion (incidence of 5.7 per 1000 live births) and were followed up for a minimum of 5 yrs. Doppler color flow mapping was performed in 98 of 124 patients. Results: 51 had a muscular VSD, 47 had a perimembranous defect; 26 were unclassified due to lack of echocardiographic data. Five patients had 2 muscular VSDs. None had a subpulmonic type of defect. 118/124 had more than 1 yr follow up and 115/124 more than 5 yrs of follow-up. Of 51 patients with muscular VSD, spontaneous closure was seen in 20 (39%) and 37 (74%) at the end of 1 yr and 5 yrs respectively. Of 47 pts with perimembranous defect, spontaneous closure was seen in 11 (23%) and 19 (40%) at the end of 1 and 5 yrs respectively. Of the unclassified 26 pts, 9 (35%) and 21 (81%) pts spontaneously closed their VSDs at 1 and 5 yrs respectively. Spontaneous closure occurred approximately twice as frequently with muscular VSD than with perimembranous defect. Surgical intervention was required in 2 (4%) of muscular VSDs and in 11 (23%) of perimembranous VSDs at 5 yrs, mostly within the first year of life. Overall the spontaneous closure rate for all types was about 62% at 5 yrs. Conclusion: 1. The incidence of VSD and of muscular VSDs in the North-east Tennessee area is higher than hitherto reported in the literature. Clinical Implications: Both at the end of first year and five years, the prognosis of muscular VSDs appears much better than of perimembranous VSDs with respect to closure and need for surgical intervention. Only 20% of infants born with VSDs appear to require long term follow-up after 5 yrs.

This document is currently not available here.

Share

COinS