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. 1999 Nov;81(5):413–416. doi: 10.1136/adc.81.5.413

The natural history of ventricular septal defects

S Turner 1, S Hunter 1, J Wyllie 1
PMCID: PMC1718115  PMID: 10519715

Abstract

AIMS—To correlate the size and position of isolated ventricular septal defects with closure rate in a cohort of children with mean follow up of more than six years.
DESIGN—A birth cohort was identified using the northern region cardiac database. The following were noted from case notes: defect size, position, means of closure, and age at closure.
RESULTS—68 children were identified. 49 defects were small, 14 were moderate, and 5 were large. 13 cases required surgical closure, including 12 perimembranous defects. 35 defects closed spontaneously. Nine of the small muscular defects remained open and five of the small perimembranous defects remained open. The spontaneous closure rate for muscular defects was significantly greater than for perimembranous defects. Mean age of follow up for patients who still have defects is 76months.
CONCLUSIONS—The position of a ventricular septal defect is extremely relevant to its natural history. Perimembranous defects accounted for most of the moderate and large defects that required surgical intervention. After more than six years almost a third of all perimembranous and just over two thirds of all muscular defects closed spontaneously.



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Selected References

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  1. Abu-Harb M., Hey E., Wren C. Death in infancy from unrecognised congenital heart disease. Arch Dis Child. 1994 Jul;71(1):3–7. doi: 10.1136/adc.71.1.3. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Ainsworth S., Wyllie J. P., Wren C. Prevalence and clinical significance of cardiac murmurs in neonates. Arch Dis Child Fetal Neonatal Ed. 1999 Jan;80(1):F43–F45. doi: 10.1136/fn.80.1.f43. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Campbell M. Natural history of ventricular septal defect. Br Heart J. 1971 Mar;33(2):246–257. doi: 10.1136/hrt.33.2.246. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Collins P., Burman J., Chung H. I., Fox K. Hemoglobin inhibits endothelium-dependent relaxation to acetylcholine in human coronary arteries in vivo. Circulation. 1993 Jan;87(1):80–85. doi: 10.1161/01.cir.87.1.80. [DOI] [PubMed] [Google Scholar]
  5. Dickinson D. F., Arnold R., Wilkinson J. L. Ventricular septal defect in children born in Liverpool 1960 to 1969. Evaluation of natural course and surgical implications in an unselected population. Br Heart J. 1981 Jul;46(1):47–54. doi: 10.1136/hrt.46.1.47. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Helmcke F., de Souza A., Nanda N. C., Villacosta I., Gatewood R., Jr, Colvin E., Soto B. Two-dimensional and color Doppler assessment of ventricular septal defect of congenital origin. Am J Cardiol. 1989 May 1;63(15):1112–1116. doi: 10.1016/0002-9149(89)90088-x. [DOI] [PubMed] [Google Scholar]
  7. Hiraishi S., Agata Y., Nowatari M., Oguchi K., Misawa H., Hirota H., Fujino N., Horiguchi Y., Yashiro K., Nakae S. Incidence and natural course of trabecular ventricular septal defect: two-dimensional echocardiography and color Doppler flow imaging study. J Pediatr. 1992 Mar;120(3):409–415. doi: 10.1016/s0022-3476(05)80906-0. [DOI] [PubMed] [Google Scholar]
  8. Hoffman J. I., Rudolph A. M. The natural history of ventricular septal defects in infancy. Am J Cardiol. 1965 Nov;16(5):634–653. doi: 10.1016/0002-9149(65)90047-0. [DOI] [PubMed] [Google Scholar]
  9. Hornberger L. K., Sahn D. J., Krabill K. A., Sherman F. S., Swensson R. E., Pesonen E., Hagen-Ansert S., Chung K. J. Elucidation of the natural history of ventricular septal defects by serial Doppler color flow mapping studies. J Am Coll Cardiol. 1989 Apr;13(5):1111–1118. doi: 10.1016/0735-1097(89)90270-2. [DOI] [PubMed] [Google Scholar]
  10. Karpawich P. P., Duff D. F., Mullins C. E., Cooley D. A., McNamara D. G. Ventricular septal defect with associated aortic valve insufficiency. Progression of insufficiency and operative results in young children. J Thorac Cardiovasc Surg. 1981 Aug;82(2):182–189. [PubMed] [Google Scholar]
  11. Ludomirsky A., Huhta J. C., Vick G. W., 3rd, Murphy D. J., Jr, Danford D. A., Morrow W. R. Color Doppler detection of multiple ventricular septal defects. Circulation. 1986 Dec;74(6):1317–1322. doi: 10.1161/01.cir.74.6.1317. [DOI] [PubMed] [Google Scholar]
  12. Meberg A., Otterstad J. E., Frøland G., Sørland S., Nitter-Hauge S. Increasing incidence of ventricular septal defects caused by improved detection rate. Acta Paediatr. 1994 Jun;83(6):653–657. doi: 10.1111/j.1651-2227.1994.tb13102.x. [DOI] [PubMed] [Google Scholar]
  13. Mehta A. V., Chidambaram B. Ventricular septal defect in the first year of life. Am J Cardiol. 1992 Aug 1;70(3):364–366. doi: 10.1016/0002-9149(92)90620-e. [DOI] [PubMed] [Google Scholar]
  14. Moe D. G., Guntheroth W. G. Spontaneous closure of uncomplicated ventricular septal defect. Am J Cardiol. 1987 Sep 15;60(8):674–678. doi: 10.1016/0002-9149(87)90380-8. [DOI] [PubMed] [Google Scholar]
  15. Shirali G. S., Smith E. O., Geva T. Quantitation of echocardiographic predictors of outcome in infants with isolated ventricular septal defect. Am Heart J. 1995 Dec;130(6):1228–1235. doi: 10.1016/0002-8703(95)90147-7. [DOI] [PubMed] [Google Scholar]
  16. Silberbach M., Sahn D. J. Three-dimensional echocardiographic reconstruction: from "ice-pick" view to virtual reality. Mayo Clin Proc. 1993 Mar;68(3):311–312. doi: 10.1016/s0025-6196(12)60055-x. [DOI] [PubMed] [Google Scholar]
  17. Sutherland G. R., Godman M. J., Smallhorn J. F., Guiterras P., Anderson R. H., Hunter S. Ventricular septal defects. Two dimensional echocardiographic and morphological correlations. Br Heart J. 1982 Apr;47(4):316–328. doi: 10.1136/hrt.47.4.316. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. van den Heuvel F., Timmers T., Hess J. Morphological, haemodynamic, and clinical variables as predictors for management of isolated ventricular septal defect. Br Heart J. 1995 Jan;73(1):49–52. doi: 10.1136/hrt.73.1.49. [DOI] [PMC free article] [PubMed] [Google Scholar]

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