Impact Of Ventricular Septal Defect Relative Factors On Spontaneous Closure

Objective:To investigate the factors related to spontaneous closure(SC) ofisolated ventricular septal defect(VSD) in children by echocardiography forbetter.Methods:All the cases with isolated VSD were diagnosed withechocardiography in Children’s Hospital of Chongqing Medical Universityfrom January2007to December2010. According to the site and diameterof VSD， divide these VSD into small, moderate, large groups orperimembranous ventricular septal defect (P-VSD), muscular ventricularseptal defect (M-VSD), subpulmonary ventricular septal defect (S-VSD)and mutiple VSD groups. All the cases were followed up withechocardiography for5years every half year. All datum wereretrospectively assessed.Results:1.Total1157cases with isolated VSD diagnosed in Children’sHospital of Chongqing Medical University from January2007to December2010. Excluding the SC and repetition cases, there was1052cases,with572cases was male and480female,aged from0day to17years old.Andthere879cases are P-VSD,40are M-VSD,119are S-VSD,14are multipleVSD.92cases were effectively followed-up. 2. All18cases were perimembranous ventricular septal defect,and11male and7female, aged from6months to9years old, average5years old,inclding12cases were under3years old. Among which3cases werealmost SC with little bypass,and15were SC formed aneurysm ofventricular membranous septum(AMVS).3.388cases were small VSD,141cases the diameter were under3mm;307cases were moderate VSD and174cases were large VSD,the diameterof VSD was related to the SC.4.Factors, including diameter, site, pulmonary artery pressure，velocity ofthe ventricle, pulmonary velocity(PV), aneurysm of ventricularmembranous septum(AVMS) and complications are involved to analyse thefactors that effect SC.Conclusion:1.Small VSD,especially under3mm diameter,the potentiality to SC ismore obviously,then can follow up to pre-school age or adolescence.2.Moderate VSD has possibility to SC,can depend the pressure、velocity of the ventricle、PV and complication to clinical manage,it also canfollow up to pre-school age but need to tightly followed byechocardiography and clinical symptoms.3.Large VSD has small potential to SC,may treat with surgery early.4.Pulmonary artery pressure increase、valve prolapse and dilation ofheart effects SC.5.Perimembranous inlet VSD or Perimembranous trabecular VSD ismore easy to SC,can follow up to pre-school age depend on the diameter.6.Perimembranous outlet VSD or S-VSD has little possibility toSC,and the complication like aortic valve prolapse may easy tooccurred,thus can treat with surgery more early.