title: Evolution of ventricular septal defect with special reference to spontaneous closure rate, subaortic ridge and aortic valve prolapse.
abstract: The medical records of 685 patients with ventricular septal defect (VSD) were reviewed to determine spontaneous closure, left ventricular-to-right atrial shunt, subaortic ridge, and aortic valve prolapse. Patients had been followed for a mean of 3 +/- 2.5 years and median 2.2 years by echocardiography. VSD was perimembranous in 65.7% (450), trabecular muscular in 30.8% (211), muscular outlet in 2.3% (16), muscular inlet in 0.7% (5), and doubly committed subarterial in 0.5% (3). Defect size was classified in 76% (517) as small, in 18% (124) as moderate, and in 6% (44) as large. VSD closed spontaneously in 27% (186 of 685 patients) by ages 40 days to 13.7 years (mean, 2.1 +/- 2.2 years; median, 1.3 years). Sixty-six of 450 perimembranous defects (15%) and 120 of 211 trabecular muscular defects (57%) closed spontaneously (p <0.001). Defect size became small in 15% of patients with VSD at mean 2.9 +/- 2.3 years (median, 2.3 years). Aneurysmal transformation was detected in 56% (254), left ventricular-to-right atrial shunt in 8.4% (38), subaortic ridge in 5.8% (26), aortic valve prolapse in 11.7% (53), and aortic regurgitation in 7.3% (33) of 450 patients with perimembranous defect. There was no statistical significance between the age at closure and the age of detection of aneurysmal transformation in the patients with perimembranous defect (p = 0.25).
mesh_terms: D000293:Adolescent; D000328:Adult; D001023:Aortic Valve Prolapse / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D006325:Heart Atria / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000601:surgery; D006352:Heart Ventricles / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D007231:Infant, Newborn; D008297:Male; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey