Atrial and ventricular septal defects - epidemiology and spontaneous closure.
OBJECTIVE
To present data on the epidemiology and spontaneous closure for septal defects (secundum atrial septal defect (ASD) and/or ventricular septal defect (VSD)).


METHODS
Data from the EUROCAT Registry of Congenital Malformations for Funen County, Denmark were analyzed. All infants born from 1986 to 1998, diagnosed with a secundum ASD and/or a VSD as the only cardiac malformation, were included.


RESULTS
There were 78 infants with an ASD, 195 with a VSD, and 19 had both an ASD and a VSD. The overall prevalence of septal defects was 4.1 per 1000 livebirths. Among the VSDs 45% were perimembranous and 55% were muscular defects. Associated non-cardiac malformations, syndromes, or karyotype anomalies were present in 54 cases (19% of total) but with a significantly lower proportion among cases with muscular VSDs (7%, p < 0.05). Eighty-one percent of the cases had an isolated cardiac malformation. Five of 61 cases (8%) with isolated ASD were closed surgically before five years of age and 43 (70%) closed spontaneously within the first five years of life. Of the 65 cases with isolated perimembranous VSDs, 13 were closed surgically (20%) and 13 closed spontaneously (20%). Of the 99 cases with isolated muscular VSDs no defects were closed by surgery and 64 (65%) closed spontaneously. The rate of spontaneous closure for perimembranous and muscular VSDs were significantly different (p < 0.0001).


CONCLUSIONS
Secundum ASD has a high rate of spontaneous closure. Perimembranous and muscular VSDs seem to be two different diseases with different epidemiology and natural history.
Garne
Ester
E
Paediatric Cardiology Unit, Odense University Hospital, DK-5000, Odense C, Denmark. Egarne@health.sdu.dk
D002869:Chromosome Aberrations; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000453:epidemiology* / Q000235:genetics / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000453:epidemiology* / Q000235:genetics / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012042:Registries; D012075:Remission, Spontaneous