Color Doppler Echocardiographic Study on the Incidence and Natural History of Early-Infancy Muscular Ventricular Septal Defect

Chang, Jia-Kan; Jien, Wen-Yen; Chen, Huilan; Hsieh, Kai‐Sheng

doi:10.1016/j.pedneo.2011.06.003

Cited by 19 publications

(13 citation statements)

References 31 publications

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“…Ventricular septal defect was the most common heart defect with a prevalence of 17.3‰ in our study, accounting two‐thirds of the total CHD. However, either high prevalence (24.9–53.2‰) or high rate of spontaneous closure (81.8–89% at 12‐month follow‐up) of muscular VSD was reported in previous studies . Our study demonstrated that spontaneous closure of muscular VSD at 3‐month follow‐up was 72%; it was in accordance with that reported by Chang et al.…”

Section: Discussionsupporting

confidence: 91%

Prevalence of congenital heart disease at live birth: an accurate assessment by echocardiographic screening

Zhao

Jia

et al. 2013

Acta Paediatrica

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Section: Discussionsupporting

confidence: 91%

Prevalence of congenital heart disease at live birth: an accurate assessment by echocardiographic screening

Zhao

Jia

et al. 2013

Acta Paediatrica

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“…Whether the position of m‐VSD affects the probability potential for spontaneous closure remains debatable. The results of this study indicated that the spontaneous closure of m‐VSD is independent of the position of the defect, which is in line with published reports . We observed that the incidence rate of mid‐muscular VSD, which is the most common position for m‐VSD, was 60% with a spontaneous closure rate of 66%.…”

Section: Discussionsupporting

confidence: 91%

Prediction of spontaneous closure of ventricular septal defect and guidance for clinical follow‐up

Ren

Song

et al. 2019

Clinical Cardiology

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Aim To predict the spontaneous closure of ventricular septal defect (VSD) and assist pediatrician to manage VSD children. Methods Between January 2008 and December 2016, 132 children diagnosed with isolated VSD by echocardiography were enrolled. All participating children were followed‐up by echocardiography yearly until the closure of VSD or 6 years old. The clinical indicators and echocardiographic parameters of patients were collected. Statistically significant factors were used to establish a Logistic Regression model for predicting spontaneous closure of VSD. Receiver operating characteristic (ROC) analysis was used to assess the specificity and sensitivity of Logistic Regression model. Results Spontaneous closure occurred in 60% of all patients; 57% in perimembranous VSD (p‐VSD) and 64% in muscular VSD (m‐VSD) patients. Initial diagnosis age, defect size, aneurysms tissue of the ventricular membranous septum (ATVMS), pulmonary hypertension (PH), and left ventricular diastolic dimension (LVDD) were statistically significant. Defect size, ATVMS and LVDD were determined by the Logistic Regression model as representative factor. P‐VSD and m‐VSD model had areas under the ROC curves 0.854 and 0.898, respectively. Conclusion We inferred that defect size, ATVMS and LVDD were characteristic and representative predictors for spontaneous closure of VSD. And we summarized the prognostic factors and recommended a follow‐up criteria to assist the pediatrician managing VSD children.

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“…Many studies have revealed a benign natural history for most VSDs 10 21–23 25 27 32–36. Muscular VSDs tend to close in 80% cases early in life,21 22 25 32–36 a frequency that is at least twice the frequency of spontaneous closure for perimembranous VSDs 25. Spontaneous closure may occur up to age 6 years25 or beyond school age for perimembranous VSDs 23.…”

Section: Resultsmentioning

confidence: 99%

Controversies in the definition and management of insignificant left-to-right shunts

Cantinotti

Assanta

Murzi

et al. 2013

Heart

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Haemodynamically insignificant left-to-right shunts are frequently discovered when screening for congenital heart disease, resulting in significant economic and psychosocial impact. A literature search was performed within the National Library of Medicine using the keywords small/insignificant/silent atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA) and patent foramen ovale (PFO). The search was refined by adding the keywords definition, classification and follow-up. Our analysis revealed significant heterogeneity in the evaluation and management of innocent left-to-right shunts. The definitions for small defects vary greatly, making it difficult to distinguish between physiologic and pathologic lesions (eg, a PFO vs a true ASD). Most small defects will partially or completely resolve spontaneously early in life. If spontaneous resolution does not occur, the risk for long-term complications (such as embolic events and endocarditis) is low but poses several practical and ethical issues: immediate discharge versus long-term follow-up, duration and frequency of follow-up, and content and method of discussions with the parents. Additionally, there is controversy pertaining to treatment for PDAs and VSDs, particularly among interventional cardiologists, even though risk/benefit analyses are lacking. Standards and guidelines using consensus opinion for the management of insignificant left-to-right shunts are needed to address the heterogeneity in diagnosis and management as well as use of resources, ethical and psychosocial issues.

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Color Doppler Echocardiographic Study on the Incidence and Natural History of Early-Infancy Muscular Ventricular Septal Defect

Abstract: Although the incidence of M-VSD was common in the neonatal period, there was also a high rate of spontaneous closure. Therefore, comparison of M-VSD appearance with the incidence of congenital heart disease in neonates had a decisive influence on analysis.

Cited by 19 publications

References 31 publications

Prevalence of congenital heart disease at live birth: an accurate assessment by echocardiographic screening

Prevalence of congenital heart disease at live birth: an accurate assessment by echocardiographic screening

Prediction of spontaneous closure of ventricular septal defect and guidance for clinical follow‐up

Controversies in the definition and management of insignificant left-to-right shunts

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