Study of clinical profile and outcome of ventricular septal defects diagnosed in infancy

Abstract

Objective: The objective of the study was to study the clinical profile and outcome of isolated ventricular septal defect (VSD) among infants visiting the departments of pediatrics and pediatric cardiology of the government hospital of South India. Infants with newly detected VSD were registered. Data regarding age at presentation, mode of detection, antenatal, natal and postnatal history, and development and growth were collected. Relevant investigations including echocardiography were done. Babies were followed up 6 monthly. At least one follow?up was done for each child with a maximum of three follow?ups unless VSD closed spontaneously. The data were analyzed using R statistical language and conclusions were drawn. Results: Almost equal gender ratio was observed. Gestational diabetes mellitus was seen in 23% of mothers. Family history of congenital heart disease was seen in 12% of patients and 5% had syndromic association. Perimembranous type of VSD was found to be the most common (52%). Small VSDs were seen in 62% of patients among which most were muscular (61%). Among the large VSDs, 57% were perimembranous. Overall, 46.2% of VSD closed spontaneously and nearly 10% reduced in size. Spontaneous closure rate was 80% for muscular VSD and 25% for perimembranous VSD. Conclusion: The moderate to large perimembranous defects and inlet and subpulmonic types of VSD are unlikely to close. These defects if detected moderate to large might be advised for early surgical closure. During parental counseling, the excellent long?term natural history of small VSDs, both muscular and perimembranous, could be emphasized, whereas those with moderate VSDs need to be kept under close follow?up and might require surgical closure.