سیر بالینی نقص بین بطنی (VSD)

Background and purpose: The purpose of the study was to asses the natural and clinical course of isolated ventricular defect in children. Materials and methods: Patients and Methods: From 1997 to 2011 we prospectively studied a total of 218 infants and children diagnosed as isolated ventricular septal defects. The Çhi-squar or Fisher exact Test and ÂNÔVÂ were used to compare the differences where appropriate. Â valve less than 0.05 was considered statistically significant. The patients who had an additional hemodynamic significant heart defect were excluded. Results: Â total of 218 patients, 125 females VS 93 males (57% VS 43%) were followed up for the mean time of 55.7 months (Range 12-170 mo) The distribution of perimembranous, muscular, subarterial and inlet type VSD were 65.1%, 32.1%, 1.4% and 1.4% respectively. Regardless of type of VSD, spontaneous closure was observed in 86 (39.5%) cases. Forty four (31%) perimembranous VSD and forty two (57.2%) muscular defect closed spontaneously. Ïnlet or subarterial defects were not closed spontaneously. Regardless of type VSDS, 71 (52.6%) of small and 15 (25%) of moderate size defect closed spontaneously. Fifty (24.3%) cases needed surgical Treatment. Âortic regurgitation developed in 11 (5%) patient. Ïnfective endocarditis was observed in 3 (1.7%) in patients. Ôther complications were pulmonary hypertension in 39 (17.9%), congestive heart failure in 12 (5.5%), sub pulmonic stenosis in 16 (7.3%) mitral regurgitation in 6 (2.8%) and sub aortic ridge in 7 (3.2%) patients. Çonclusion: Ït is concluded that patients with VSD should be followed closely through life because the complications such as pulmonary hypertension, Ëisenmenger syndrome, infective endocarditic sub pulmonic stenosis, aortic ridge and aortic regurgitation may develop, although spontaneous closure of the defect is to be expected in many cases (39.51%), a significant percentage of defects may need surgical treatment (24.3%).