Doubly committed ventricular septal defect: single-centre experience and midterm follow-up.
BACKGROUND
Doubly committed ventricular septal defect (dcVSD) is the least common type of VSD. Because published studies are rather scarce, this study aimed at evaluating the midterm outcome of dcVSDs.


METHODS
The records of all patients registered in the database of Paediatric and Congenital Cardiology, University Hospitals Leuven, with a dcVSD at 16 years of age were reviewed. Clinical, electrocardiographic and transthoracic echocardiographic changes from baseline, defined as of the age of 16 years, until the latest follow-up were compared.


RESULTS
Thirty-three patients (20 males, median age 26 years, interquartile range 12) were followed for a median time of 7.9 years (interquartile range 9.8, time range 2-25.9). No deaths occurred. In 15 patients (45%), the defect remained patent at baseline. During follow-up, two spontaneous closures (13%) occurred. Eighteen patients (55%) required closure before the age of 16 years. Five (28%) needed reoperation. In the dcVSD closure group, left ventricular ejection fraction decreased from 69 ± 12 to 61 ± 6% (p = 0.028). No significant changes in pulmonary arterial hypertension were noticed.


CONCLUSIONS
Patients with persistently patent dcVSD remained nearly event free during follow-up. Event-free survival after dcVSD closure was markedly lower. These patients developed reduced left ventricular function and had a high risk of reintervention.
Department of Congenital Cardiology, University Hospitals Leuven, Leuven, Belgium.
Charlien
C
Gabriels
Marc
M
Gewillig
Bart
B
Meyns
Els
E
Troost
Alexander
A
Van De Bruaene
Sara
S
Van Damme
Werner
W
Budts
D000328:Adult; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000401:mortality* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011379:Prognosis; D011666:Pulmonary Valve Stenosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D012075:Remission, Spontaneous; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology