title: Evaluation of Ventricular Septal Defect with Special Reference to the Spontaneous Closure Rate, Subaortic Ridge, and Aortic Valve Prolapse II.
abstract: The medical records of 2283 patients with ventricular septal defect (VSD) were reviewed to determine spontaneous closure, left ventricular-to-right atrial shunt, subaortic ridge, and aortic valve prolapse. One thousand eight hundred and twenty-three patients had been followed 1 month to 26 years (median 4 years) by echocardiography. Most of 460 patients could not be followed due to transportation of the institution. VSD was perimembranous in 68.8% (1255), trabecular muscular in 21.7% (395), muscular outlet in 6% (109), muscular inlet in 2.6% (48), and doubly committed subarterial in 0.9% (16). Defect size was classified in 66.8% (1218) as small, in 15.7% (286) as moderate, and in 17.5% (319) as large. VSD closed spontaneously in 18.8% (343 of 1823 patients) by ages 40 days to 24.9 years (median, 1.8 years). One hundred fifty-seven of 1255 perimembranous defects (12.5%) and 167 of 395 trabecular muscular defects (42%) closed spontaneously (p < 0.001). Defect size became small in 306 (16.8%) of patients with VSD at a median of 2.5 years. Aneurysmal transformation was detected in 32.9% (600), left ventricular-to-right atrial shunt in 9.7% (176), subaortic ridge in 2.6% (48) of 1823 patients who were followed. In 381 (20.9%) of the 1823 patients, the VSD had been closed by a surgical or transcatheter technique. Surgery is required in one-fifth of patients with subaortic ridge or aortic valve prolapse. In conclusion, isolated VSDs are usually benign abnormalities that tend to shrink and close spontaneously.
authors.affiliation: Department of Paediatric Cardiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Ayse Guler
authors.initials: AG
authors.lastname: Eroglu
authors.affiliation: Department of Paediatric Cardiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. sezenugan@hotmail.com.
authors.forename: Sezen Ugan
authors.initials: SU
authors.lastname: Atik
authors.affiliation: Department of Paediatrics, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Esma
authors.initials: E
authors.lastname: Sengenc
authors.affiliation: Department of Public Health, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Gulnaz
authors.initials: G
authors.lastname: Cig
authors.affiliation: Department of Paediatric Cardiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Irfan Levent
authors.initials: IL
authors.lastname: Saltik
authors.affiliation: Department of Paediatric Cardiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Funda
authors.initials: F
authors.lastname: Oztunc
mesh_terms: D000293:Adolescent; D000328:Adult; D001023:Aortic Valve Prolapse / Q000150:complications; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000145:classification / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012039:Regional Blood Flow; D012075:Remission, Spontaneous; D055815:Young Adult
keywords: Aortic valve prolapse; Left ventricular-to-right atrial shunt; Spontaneous closure; Subaortic ridge; Ventricular septal defect