Spontaneous closure of ventricular septal defects in the first year of life

Background and purpose: The recent increase in the prevalence of ventricula r Septal defect (VSD) has been ascribed to the improved detection of small defects with echocardiography and the wider use of screening. The aim of th is study was to determine the prevalence and timing of spontaneous closure of specific types of VSD in neonates using echocardiographic screening and follow-up. Methods: Two-dimensional color Doppler echocardiography was performed in 3, 472 clinically normal full-term neonates born at Cathay General Hospital to detect isolated VSD. The relative prevalence of muscular versus perimembra nous defects and their outcome in the first year of life were evaluated. Results. VSD was found in 74 neonates (34 male, 40 female), resulting in a prevalence of 21.3/1,000 live births. There were 48 muscular, 25 perimembra nous, and one subpulmonic defects. Of the 74 patients, 11 were lost to foll ow-up. Within the observation period of 12 months, spontaneous closure occu rred in 40 patients in the muscular group and in six patients in the perime mbranous group. The overall rate of spontaneous closure was 73% by the end of the first year. Only five patients with perimembranous defects received digoxin therapy. Conclusions: The prevalence of VSD in this series of neonates was 21.1/1,00 0 live births. The most common location of VSD in the neonatal period was i n the region of the muscular septum. Muscular defects were more likely to c lose spontaneously than perimembranous defects. Most muscular defects under went spontaneous closure during the 12-month follow-up period.