Spontaneous Closure of Small Ventricular Septal Defects

Alpert, Bruce S.

doi:10.1001/archpedi.1973.04160020028005

Cited by 68 publications

(21 citation statements)

References 10 publications

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Section: Discussionmentioning

confidence: 95%

“…6 Again, the incidence of this complication varies widely in previous reports, ranging from 1% to15%. 6,7 Variations reflect the difficulty of estimating the true incidence of this complication. 5 Shah et al 23 estimated the risk of a 15-year-old with a VSD developing bacterial endocarditis by age 70 to be 11.5%.…”

Section: Discussionmentioning

confidence: 95%

“…3,4 Operation were postponed on the observation that VSDs frequently close spontaneously. 5,6 The patients with such small defects are unlikely to develop pulmonary hypertension and that the clinical outcome was assumed to be good. 4 The natural history of VSD is also characterized by many complications.…”

Section: Introductionmentioning

confidence: 99%

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Small Ventricular Septal Defect Considered Not Requiring Surgical Closure: The Frequency of Developing Complications in Our Center

Hyder¹,

Kazmi²,

Kazmi³

2016

Heart Res Open J

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Objectives:The study was conducted to check the frequency of development of complication in the patients with small Ventricular Septal Defects (VSDs) considered not requiring surgical closure during childhood. Methods: A descriptive study was conducted on children from January 2015 to December 2015 at Children Hospital and Institute of Child Health, Lahore, Pakistan. The data with isolated VSDs considered too small to require surgery from 1 month to 15 years of age were reviewed. The data was analyzed with SPSS 20 version. Results: The total of 883 patients of restrictive VSDs considered not to require surgery, 60.6% (n=535) were males and 39.4% (n=348) were females. The significant number of patients i.e. 18.7% (n=166) developed complications. Aortic cusp prolapsed developed in 13.6% i.e. p≤0.05, 2.3% developed aortic regurgitation secondary to aortic cusp prolapsed. 1.8% developed right ventricular track outflow obstruction (RVOT) i.e. p≤0.05 and 0.3% of patient developed left ventricular outflow track obstruction (LVOT) i.e. p≤0.05. Similarly 0.8% patients developed endocarditis. Regarding types of VSD, we found Perimembranous in 65.8%, muscular in 12.6%, Subaorticin 8.3%, doubly committed in 6.0%, Inlet in 5% and outlet in 1.7% of our patients. Conclusions: Patients with small restrictive Ventricular Septal Defects (VSDs) generally been considered as do not required surgery, the data suggested that a significant percentage of these patients developed complications later in their life i.e., 18.7%.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

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Small Ventricular Septal Defect Considered Not Requiring Surgical Closure: The Frequency of Developing Complications in Our Center

Hyder¹,

Kazmi²,

Kazmi³

2016

Heart Res Open J

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“…VSD is usually asymptomatic and often closes spontaneously (19). The reported rates of spontaneous closure vary between 50% and 75% in small defects (20)(21)(22). Therefore, the prevalence of VSD should be higher in neonates.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Clinical Characteristics of Congenital Heart Disease among Neonates in Neonatal Intensive Care Unit

Korkmaz¹

2015

AJHR

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Abstract:Background: Congenital heart diseases affect a large number of newborns and account for a high proportion of infant mortality worldwide. There are regional differences in the prevalence and distribution pattern of congenital heart diseases. We aimed to evaluate the relative frequencies, risk factors and diagnostic clues of congenital heart disease in newborns at our neonatal intensive care unit. Materials and methods: Among 326 cases admitted to the Abant Izzet Baysal University Neonatal Intensive Care Unit between February 2013 -September 2014, thirty-five newborns with congenital heart disease were evaluated, retrospectively. Data was collected on a predesigned proforma containing information regarding gender, gestational age and weight at birth, family history, and associated malformations. Results: The prevalence of congenital heart disease was 10.7%. The most common cause for cardiology consultation was cardiac murmur (85.5%). The relative percentage of acyanotic and cyanotic heart defects were 91.6% and 8.4%, respectively. The most frequent acyanotic defect was ventricular septal defect with a prevalence of 22.8%. Maternal diabetes mellitus and Down syndrome were observed in 17.1% and 2.8% of cases, respectively. Conclusion: The prevalence of congenital heart disease in newborns at the neonatal intensive care unit was higher than that in all live births and most common defect was muscular VSD. The most frequent diagnostic clue was cardiac murmur.

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“…3,7,10,11 Spontaneous closure has been reported in small and large defects. [12][13][14][15] Even defects large enough to produce congestive heart failure or require pulmonary artery banding in infancy have been reported to close naturally. 3,6,[14][15][16][17][18][19][20][21] Such occurrences in isolated VSDs are clearly beneficial to the patients with resultant abatement of symptoms.…”

Section: Introductionmentioning

confidence: 99%

The Ventricular Septal Defect in Tricuspid Atresia: Its Natural History and Surgical Importance

Rao

1983

Ann Saudi Med

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We have previously reported anatomic and functional closure of ventricular septal defects (VSDs) in tricuspid atresia. To study this phenomenon further, clinical, angiographic, and pathologic findings in 40 consecutive cases of tricuspid atresia were reviewed. In 14 of these patients, there was evidence of closure of the VSD; in eight it was complete and in the other six partial. Eleven of these VSD closures occurred in type 1 (without transposition) patients and three among type II (with transposition). Progressive cyanosis, increasing polycythemia and/or disappearance of a previously heard murmur were observed in all patients; these signs were more conspicuous in complete than in partial closure. The incidence of closure of VSD in this lesion was 35 percent but when tricuspid atresia patients without VSD are excluded, the incidence increases to 42 percent. Progressive muscular "encroachment" of the margins of the VSD with subsequent fibrosis and covering by endocardial proliferation is the most likely mechanism of closure. Previous surgical shunts played no role in VSD closure. For initial palliation, a Blalock-Taussig shunt (preferably on the left side) is recommended in preference to a Glenn anastomosis, because the latter may leave the left pulmonary circuit without blood supply if the VSD closes. If further palliation is required prior to a Fontan type of operation, a Blalock-Taussig shunt on the right side, Glenn anastomosis or enlargement of VSD could be performed. In type II patients, a large and non-restrictive VSD is essential for survival following a Fontan operation. Therefore, the size of the VSD should be evaluated prior to and at the time of surgical correction. If the VSD is small in type II cases, complete bypass of the VSD and right ventricle either by a pulmonary artery-to-ascending aorta or left ventricle-to-descending aorta conduit should be performed. This is preferable to resection of the ventricular septum or creation of an aortopulmonary window proximal to pulmonary artery banding.

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Spontaneous Closure of Small Ventricular Septal Defects

Cited by 68 publications

References 10 publications

Small Ventricular Septal Defect Considered Not Requiring Surgical Closure: The Frequency of Developing Complications in Our Center

Small Ventricular Septal Defect Considered Not Requiring Surgical Closure: The Frequency of Developing Complications in Our Center

Incidence and Clinical Characteristics of Congenital Heart Disease among Neonates in Neonatal Intensive Care Unit

The Ventricular Septal Defect in Tricuspid Atresia: Its Natural History and Surgical Importance

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