Hostname: page-component-77c89778f8-vpsfw Total loading time: 0 Render date: 2024-07-21T21:58:41.108Z Has data issue: false hasContentIssue false

Spontaneous closure of muscular ventricular septal defect identified by echocardiography in neonates

Published online by Cambridge University Press:  19 August 2008

Zhong-Dong Du*
Affiliation:
Heart Institute, Western Galilee Hospital-Nahariya, Technion Faculty of Medicine, Israel
Nathan Roguin
Affiliation:
Heart Institute, Western Galilee Hospital-Nahariya, Technion Faculty of Medicine, Israel
Xing-Jian Wu
Affiliation:
Heart Institute, Western Galilee Hospital-Nahariya, Technion Faculty of Medicine, Israel
*
Present address and address for reprints: Dr. Zhong-Dong Du, Division of Cardiology, Capital Institute of Pediatrics, No. 2, Ya Bao Road, 100020 Beijing, China. Tel: 86-10-8032086; Fax: 86-10-5128367

Abstract

Muscular ventricular septal defects were diagnosed by echocardiography in 97 neonates within 7 days of birth. In 82 of the neonates (84.5%), the defect was solitary, while 15 had multiple defects. The solitary defects was located at mid-septal, apical, anterior and inlet locations in 42 (51.2%), 21 (25.6%), 14 (17.1%) and 5 (6.1%) neonates, respectively. Multiple defects occurred in the apical, anterior and mid-septal areas. The diameter of the solitary defects ranged from 1 to 6 mm (2.3 ± 0.8 mm), while the multiple lesions were 1 to 4 mm in diameter (2.1 2.3 ± 0.8 mm 0.8 mm) in 28 instances in which they could measured. It proved possible to follow 79 of the patients for period of 10 to 13 months. The defects closed spontaneously in 56 (84.8%) of 66 patients with a single defect, and in 7 (53.8%) of 13 of those with multiple defects (P<0.05). For the solitary defects, the position and size were factors determining the likelihood and speed of closure. Defects located at the apical septum, or defects larger than 4 mm in diameter, closed slowly and at a later stage. Echocardiography is an useful technique in establishing of natural history of muscular ventricular septal defects encountered in neonates.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Roguin, N, Du, Z-D, Barak, M, Nasser, N, Hershkowitz, S, Milgram, E. High prevalence of muscular ventricular septal defect in neonates. J Am Coll Cardiol 1995;26:15451548.CrossRefGoogle ScholarPubMed
2.Du, Z-D, Roguin, N, Barak, M, Bihari, SG, Ben-Elisha, M. High prevalence of muscular ventricular septal defect in preterm neonates. Am J Cardiol 1996;78:11831185.CrossRefGoogle ScholarPubMed
3.Trowitzsch, E, Braun, W, Stute, M, Pielemeier W Diagnosis, therapy, and outcome of ventricular septal defects in the 1st year of life: a two-dimensional colour-Doppler echocardiogra-phy study. Eur J Pediatr 1990;149:758–761.CrossRefGoogle ScholarPubMed
4.Hiraishi, S, Agata, Y, Nowatari, M, Oguchi, K, Misawa, H, Hirota, H, et al. Incidence and natural course of trabecular ven tricular septal defect: two-dimensional echocardiography and color Doppler flow imaging study. J Pediatr 1992;120: 409415.CrossRefGoogle Scholar
5.Hoffman, JIE, Rudolph, AM. The natural history of ventricular septal defects in infancy. Am J Cardiol 1965;16:634653.Google Scholar
6.Hornberger, LK, Sahn, DJ, Krabill, KA, Sherman, FS, Swensson, RE, Pesonen, E, Hagen-Ansert, S, and Chung, KJ. Elucidation of the natural history of ventricular septal defects by serial Doppler color flow mapping studies. J Am Coll Cardiol 1989;13:11111118.Google Scholar
7.Ramaciotti, C, Vetter, JM, Bornemeeier, RA, Chin, AJ. Prevalence, relation to spontaneous closure, and association of muscular ventricular septal defects with other cardiac defects. Am J Cardiol 1995;75:6165.Google Scholar
8.Moe, DG, Guntheroth, WG. Spontaneous closure of uncomplicated ventricular septal defect. Am J Cardiol 1987;60:674678.Google Scholar
9.Williams, RG. Doppler flow mapping and prediction of ventricular septal defect outcome. J Am Coll Cardiol 1989;63:11191121.Google Scholar
10.Ortiz, E, Robinson, PJ, Deanfield, JE, Franklin, R, and MaCartney, FJ. Localization of ventricular septal defects by simultaneous display of superimposed colour Doppler and cross sectional echocardiographic images. Br Heart J 1985;54:5360.Google Scholar
11.Ludomirsky, A, Huhta, JC, Vick, GW, Murphy, DJ, Danford, DA, and Morrow, WR. Color Doppler detection of multiple ventricular septal defects. Circulation 1986; 74:13171322.Google Scholar
12.Helmcke, F, Souza, Ade, Nanda, NC, Villacosta, I, Gatewood, R Jr., Colvin, E, and Soto, B. Two-dimensional and color Doppler assessment of ventricular septal defect of congenital origin. Am J Cardiol 1989;63:11121116.CrossRefGoogle ScholarPubMed
13.Johnson, TB, Fyfe, DA, Thompson, RP, Kline, CH, Swindle, MM, and Anderson, RH. Echocardiographic and anatomic correlation of ventricular septal defect morphology in newborn Yucatan pigs. Am Heart J 1993; 125:10671072.Google Scholar
14.Sahn, DJ, De Maria, A, Kisslo, J, Weyman, A. Committee on M-mode Standization of the American Society of Echocardiogaphy: recommendations regarding quantification in M-mode echocardiography: results of a survey of echocar diographic measurements. Circulation 1978;58:10721083.Google Scholar
15.Soto, B, Becker, AE, Moulaert, AJ, Lie, JT, and Anderson, RH. Classification of ventricular septal defects. Br Heart J 1980;43:332343.Google Scholar
16.Graham, TP Jr, Gutgescell, HE Ventricular septal defect. In: Emmanouilides, GC, Allen, HD, Riemenschneider, TA, Gutgescell, HP (eds). Moss and Adams' Heart Disease Heart Disease in Infants, Children, and Adolescents, Including the Fetus and Young Adults. 5th edition, Williams & Wilkins, Baltimore, 1995:724746.Google Scholar
17.Snider, AR, and Bengur, AR. Two-dimensional and Doppler echocardiography in the evaluation of congenital heart disease, in Marcus, ML, Schelbert, HR, Skorton, DJ, Wolf, GL, Braunwald, E. Edi. Cardiac Imaging, A companion to Braunwald's Heart Disease. WB.Saunders Company, Philadelphia, PA. 1991:479510.Google Scholar
18.Capelli, H, Andrade, JL, Somerville, J. Classification of the site of ventricular septal defect by 2-dimensional echocardiography. Am J Cardiol 1983;51:14741480.Google Scholar
19.Kirklin, JK, Castaneda, AR, Keane, JF, Fellows, KE, Norwood, WI. Surgical management of multiple ventricular septal defects. J Thorac Cardiovasc Surg 1980;80:485493.Google Scholar
20.Wenink, ACG, Oppenheimer-Dekker, A, and Moulaert, AJ. Muscular ventricular septal defects: a reappraisal of the anatomy. Am J Cardiol 1979:43:259264.CrossRefGoogle ScholarPubMed
21.Baker, EJ, Leung, MPAnderson, RH, Fischer, DR, Zuberbuhler, JR. The cross sectional anatomy of ventricular septal defects: a reappraisal. Br Heart J 1988;59:339351.CrossRefGoogle ScholarPubMed
22.Hagler, DJ, Edwards, WD, Seward, JB, Tajik, AJ. Standardized nomenclature of the ventricular septum and ventricular septal defects, with applications for two-dimensional echocardiogra phy. Mayo Clin Proc 1985;60:741752.Google Scholar
23.Grant RP Notes on the muscular architecture of the left ven tricle. Circulation 1965;32:301308.Google Scholar
24.Hoffman, JIE, Christianon, R. Congenital heart disease in a cohort of 195O2 births with long-term follow-up. Am J Cardiol 1978;42:641647.Google Scholar