Color Doppler echocardiographic study on the incidence and natural history of early-infancy muscular ventricular septal defect.
BACKGROUND
Most small muscular ventricular septal defect (M-VSD) types have been diagnosed using color Doppler echocardiography. The purpose of this study was to understand the incidence of small M-VSD in the neonatal period and analyze the natural history of these M-VSDs.


METHODS
All individuals in our study were neonates delivered at term who had a normal healthy appearance. Each accepted neonate had an examination with complete color Doppler echocardiography once before discharge. If the examination was confirmed for M-VSD, the study participants were then classified according to defect type. Further examination was arranged with color Doppler echocardiography at 1 month, 2 months, 4 months, 6 months, 9 months, and 12 months of age or until there was complete spontaneous closure.


RESULTS
Among 2891 neonates, we found that 72 (24.9/1000) were diagnosed with M-VSD. Among this group, 38 were male and 34 were female. Only six infants were lost to follow-up. Fifty-four of the 66 infants (81.8%) had M-VSD closed spontaneously at 12 months' follow-up. Significantly, 33 of 37 infants (89.2%) with mid-muscular type, the most common type of M-VSD, closed within the 1(st) year of life compared with apical type (17/24:70.8%). Four of the five infants (80%) had anterior type M-VSD closed. Infants with posterior type M-VSD were not seen during this study period.


CONCLUSIONS
Although the incidence of M-VSD was common in the neonatal period, there was also a high rate of spontaneous closure. Therefore, comparison of M-VSD appearance with the incidence of congenital heart disease in neonates had a decisive influence on analysis.
Department of Pediatrics, Cheng-Hsin General Hospital, Taipei, Taiwan.
Jia-Kan
JK
Chang
Wen-Yen
WY
Jien
Hui-Lan
HL
Chen
Kai-Sheng
KS
Hsieh
D018618:Echocardiography, Doppler, Color; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male