Ventricular Septal Defect; Incidence, Morbidity, and Mortality in Various Age Groups

Abstract

Twenty-five patients who had a proven isolated small ventricular septal defect (VSD) when they were children were re-examined 3 to 19 years later, at the age of 20-21 years. Spontaneous closure was diagnosed if the murmur had disappeared and all other cardiological findings were normal. This was so in nine patients. Six of them had previously been followed to eight years or more with the definite diagnosis of VSD. In the three others who had only been followed to the age of 3-5 years the time of closure, whether early or late, could not be assessed.

Case Details

Clinical Characteristics

The small defects identified clinically had the highest closure rate (26%).

Remission Characteristics

The 630 cases followed from infancy for an average of 7.5 years with an overall closure rate of 17%. Among the 295 cases followed through the teens into the twenties 4% closed spontaneously.

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Additional Notes

The present study is an attempt to arrive at a clearer recognition of the true prevalence of ventricular septal defect and the various responses to it of the human body. There are a variety of figures given in the literature of the last 2 to 12 years on the incidence of spontaneous closure of the ventricular septal defect: (1) Keith, Rowe, and Vlad (1958), 10% closing; (2) Hoffman and Rudolph (1965), 24% closing; (3) Ash (1964), 15% closing; (4) Li et al. (1969), 22% closing. Perhaps equally important is to recognize early in life which cases are likely to close of their own accord, particularly in the first year or two of life.