Doubly Committed Ventricular Septal Defect: Single-Centre Experience and Midterm Follow-Up

Abstract

Background: Doubly committed ventricular septal defect (dcVSD) is the least common type of VSD. Because published studies are rather scarce, this study aimed at evaluating the midterm outcome of dcVSDs. Methods: The records of all patients registered in the database of Paediatric and Congenital Cardiology, University Hospitals Leuven, with a dcVSD at 16 years of age were reviewed. Clinical, electrocardiographic and transthoracic echocardiographic changes from baseline, defined as of the age of 16 years, until the latest follow-up were compared. Results: Thirty-three patients (20 males, median age 26 years, interquartile range 12) were followed for a median time of 7.9 years (interquartile range 9.8, time range 2–25.9). No deaths occurred. In 15 patients (45%), the defect remained patent at baseline. During follow-up, two spontaneous closures (13%) occurred. Eighteen patients (55%) required closure before the age of 16 years. Five (28%) needed reoperation. In the dcVSD closure group, left ventricular ejection fraction decreased from 69 ± 12 to 61 ± 6% (p = 0.028). No significant changes in pulmonary arterial hypertension were noticed. Conclusions: Patients with persistently patent dcVSD remained nearly event free during follow-up. Event-free survival after dcVSD closure was markedly lower. These patients developed reduced left ventricular function and had a high risk of reintervention.

Long-Term Outcome of Patients with Perimembranous Ventricular Septal Defect: Results from the Belgian Registry on Adult Congenital Heart Disease

“…The prevalence of moderate AR during follow-up after surgical VSD repair ranges from 2 to 17% in the literature, depending mainly on the type of VSD studied and the presence or absence of associated aortic valve malformations and/or surgery [10,14,21,28]. In unrepaired VSD, there is also a wide range of AR development, of between 2 and 20% [16].…”

Survival and outcomes of isolated neonatal ventricular septal defects: A population-based study from a middle-income country

“…This study revealed that perimembranous and outlet VSDs have a higher spontaneous closure rate than previous studies. [ 17 20 21 22 ] The findings indicate that one out of every five outlet VSDs and one out of every two perimembranous VSDs tend to close spontaneously. This higher closure rate could be attributed to early diagnosis of VSD and longer follow-up duration in this cohort.…”

Clarifying the Natural History of the Doubly Committed Ventricular Septal Defect

“…For several years, the popular way of differentiating the lesion from the much commoner variant, now usually described as being perimembranous [2] , was to consider the commoner form to be infracristal, whereas the lesion In this issue of Cardiology , Gabriels and colleagues [1] provide a superb account of the clinical evolution of patients born with a doubly committed ventricular septal defect. Their study is remarkable on several accounts.…”