title: Spontaneous closure of muscular trabecular ventricular septal defect: comparison of defect positions.
abstract: OBJECTIVE
  To evaluate the timing and frequency of spontaneous closure of the muscular trabecular ventricular septal defect (VSD).
  
  
  METHODS
  We performed a historical cohort study for which 150 patients <3 months of age (median age, 9 days) diagnosed as having a muscular trabecular VSD were selected. Median age at latest follow-up was 2.8 years. Another 32 patients diagnosed after 3 months of age were also reviewed. Using colour Doppler, defects were classified into three groups: anterior, apical and midventricular.
  
  
  RESULTS
  Spontaneous closure occurred in 126 patients (84%): anterior, 36 of 47 (83%); apical, 26 of 31 (84%); and midventricular, 64 of 72 (89%). Multivariate analyses showed a lower frequency of spontaneous closure for patients of age of ≥ 20 days at initial echocardiography [hazard ratio 0.60, 95% confidence interval (CI) 0.39-0.89] and for anterior and apical muscular trabecular VSD (hazard ratio 0.66, 95% CI 0.47-0.95). The prevalence of the midventricular muscular trabecular VSD was significantly lower in patients ≥ 3 months of age at initial echocardiography than in those < 3 months (p = 0.010).
  
  
  CONCLUSIONS
  We infer that midventricular muscular trabecular VSD tends to close spontaneously earlier and more frequently than either anterior or apical muscular trabecular VSD.
authors.affiliation: Department of Pediatrics, Kinki University School of Medicine, Osakasayama, Japan. miyake@kpcd.med.kindai.ac.jp
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Miyake
authors.forename: Tohru
authors.initials: T
authors.lastname: Shinohara
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Inoue
authors.forename: Satoshi
authors.initials: S
authors.lastname: Marutani
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Takemura
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018618:Echocardiography, Doppler, Color; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D012075:Remission, Spontaneous; D012189:Retrospective Studies