Amal Saud Hrahsheh, Issa Saleh Hijazi.
Natural and modified history of Ventricular Septal Defects in Infants.
Pak J Med Sci Jan ;22(2):136-40.

Objective: To evaluate the natural and modified history of isolated ventricular septal defects in the first two years of life. Settings: Queen Alia Heart Institute, King Hussein Medical Center, Amman- Jordan. Patients and Methods: We prospectively studied a total of 117 infants diagnosed as isolated ventricular septal defect between June 2001-December 2002. Infants aged less than three months, with isolated membranous or muscular ventricular septal defects were followed for two years. Infants with Down syndrome, other types of ventricular septal defect and those who had an additional hemodynamic significant heart defect were excluded. Results: A total of 113 infants 62 males vs. 51 females (55% vs. 45%) were followed up for 24 months. The mean age at the time of diagnosis was 2.0 months±15 days (Range: 1 day-3.0 months). 67 patients had muscular (59.0%) and 46 had membranous ventricular septal defects (41.0%). There were 71 small (62.0%) and 42 moderate and large size defects (38.0%). 45 of muscular defects closed spontaneously, 6 were closed surgically and 16 remained open (59.0%, 8.0%, and 33.0% respectively). On the other hand 11 of membranous defects closed spontaneously surgical closure of the defect were needed in 16 infants and 19 membranous ventricular septal defects remained open by the end of the study (24.0 %, 35.0 % and 41.0% respectively). Regardless of type, 27(64.0%) of moderate and large size defects needed medical and/or surgical treatment in the first two yeas of life and 15 defects (36.0%) had their size decreased. Conclusion: Infants with muscular ventricular septal defects have better prognosis and infants with moderate and large ventricular septal defects usually need medical and/or surgical treatment.

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