Original article
Incidence and natural course of trabecular ventricular septal defect: Two-dimensional echocardiography and color Doppler flow imaging study*

https://doi.org/10.1016/S0022-3476(05)80906-0Get rights and content

This study was designed to determine the prevalence of trabecular ventricular septal defect (t-VSD) in neonates and to evaluate the effects of its location, morphologic features, and size on its natural course during infancy. One thousand twenty-eight term newborn infants were examined by color Doppler flow imaging with orthogonal ultrasonographic views. Ten giris and 11 boys (2.0%) were found to have t-VSD. The natural course of the defect was examined in 42 consecutive cases, consisting of this group of 21 neonates and another group of 21 neonates with t-VSD. The morphologic features of the defect within the trabecular septum were classified as one or two defects (36 cases) and as a meshlike defect (six cases). Reduction in size began from the right ventricular side or from within the trabecular septum. Spontaneous closure occurred most commonly during the first 6 months of life and was observed in 32 cases (76%) by 12 months of age: the frequency of closure was not related to the morphologic features and the initial size of the defect, but apical defects tended to have higher persistent patency than did defects in other locations (p<0.05). We conclude that the frequency of t-VSD in neonates and the frequency of spontaneous closure during early infancy are higher than previously believed. This information is important for predicting the natural course of t-VSD and deciding on its proper management.

References (27)

  • KapustaL et al.

    The usefulness of cross-sectional Doppler flow imaging in the detection of small ventricular septal defects with left-to-right shunt

    Eur Heart J

    (1987)
  • SutherlandGR et al.

    Colour flow imaging in the diagnosis of multiple ventricular septal defects

    Br Heart J

    (1989)
  • OnoS et al.

    Muscular ventricular septal defects detected in the early neonatal period

    Journal of the Japan Pediatric Society

    (1990)
  • Cited by (84)

    • Congenital Heart Disease: A Clinical, Pathological, Embryological, and Segmental Analysis

      2022, Congenital Heart Disease: A Clinical, Pathological, Embryological, and Segmental Analysis
    • Spontaneous Closure Rates of Ventricular Septal Defects (6,750 Consecutive Neonates)

      2019, American Journal of Cardiology
      Citation Excerpt :

      However, in reality, the frequency of nonlarge VSD follow-up and the determination of the chance that SC may occur remains a clinical dilemma.11,12 Although there have been many reports on the incidence and SC of VSD,3–10,16–21 the results have been inevitably varied due to differences in the age, sample size, screening methods, and follow-up time. It can be argued that the only way to provide accurate VSD prevalence and SC rate is to echocardiographically screen and follow up a sufficient number of consecutive births.

    • Identification of a novel and functional mutation in the TBX5 gene in a patient by screening from 354 patients with isolated ventricular septal defect

      2017, European Journal of Medical Genetics
      Citation Excerpt :

      Ventricular septal defect (VSD) is one of the most common types of CHD. Previous studies showed that up to 4% of asymptomatic neonate had VSD at birth (Hiraishi et al., 1992). Accumulating evidence indicates that genetic defects play important roles in the pathogenesis of congenital VSD.

    • Color doppler echocardiographic study on the incidence and natural history of early-infancy muscular ventricular septal defect

      2011, Pediatrics and Neonatology
      Citation Excerpt :

      Many factors could have contributed to this significant difference. Some authors agreed that most of these M-VSDs in the neonatal period were difficult to diagnose, especially apical septum defects or other very small defects, which can now be examined by color Doppler echocardiography.13–15,18–21,27–34 Spontaneous closure is the most exciting aspect of the natural history of M-VSDs.

    View all citing articles on Scopus
    *

    Supported by a grant from Kitasato University Foundation and a Grant-in-Aid for General Scientific Research from the Ministry of Education, Science, and Culture of Japan.

    View full text