Alona Raucher Sternfeld1,2, Amichai Sheffy3, Akiva Tamir1,2, Yossi Mizrachi3,4, Sagie Assa1, Mordechai Shohat3,5,6, Rachel Berger5, Dorit Lev3,7, Liat Gindes3,4. 1. Pediatric Cardiology Unit, Department of Pediatrics, Wolfson Medical Center, Holon, Israel. 2. Pediatric Cardiology Clinic, Maccabi Health Services, Rehovot, Israel. 3. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 4. Ultrasound Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel. 5. Genetic Institute, Maccabi HMO, Rehovot, Israel. 6. Bioinformatics Unit, Sheba Cancer Research Center, Sheba Medical Center, Tel Aviv, Israel. 7. Rina Mor Institute of Medical Genetics, Wolfson Medical Center, Holon, Israel.
Abstract
OBJECTIVES: We assessed the natural history of the different types of isolated ventricular septal defects (VSDs) diagnosed by fetal echocardiography and analyzed their postnatal outcomes. METHODS: This is a retrospective cohort study of 86 fetuses with isolated VSDs, detected in 7466 sequential echocardiographic examinations. The subtype and size of the VSDs were assessed during fetal life and the following birth. Data on the spontaneous closure of the VSD, need for intervention, additional abnormalities and chromosomal aberrations was analyzed. RESULTS: From the original cohort 75 cases of isolated VSDs with complete data on outcome were further analyzed. Muscular and perimembranous VSDs were found in 85.3 and 14.7%, respectively. Spontaneous closure of the VSDs occurred prenatally in 31/64 and 3/11 of fetuses with muscular VSD and perimembranous VSD, respectively. Spontaneous closure of the VSD by the age of 2 years occurred in 92.2 and 45.5% of cases with muscular and perimembranous VSDs respectively (p = 0.001). CONCLUSION: Isolated muscular VSDs usually close spontaneously during pregnancy or in the first 2 years of life and probably do not increase the risk for chromosomal aberrations. On the other hand, isolated perimembranous VSDs may need intervention following birth and may be associated with a chromosomal anomaly.
OBJECTIVES: We assessed the natural history of the different types of isolated ventricular septal defects (VSDs) diagnosed by fetal echocardiography and analyzed their postnatal outcomes. METHODS: This is a retrospective cohort study of 86 fetuses with isolated VSDs, detected in 7466 sequential echocardiographic examinations. The subtype and size of the VSDs were assessed during fetal life and the following birth. Data on the spontaneous closure of the VSD, need for intervention, additional abnormalities and chromosomal aberrations was analyzed. RESULTS: From the original cohort 75 cases of isolated VSDs with complete data on outcome were further analyzed. Muscular and perimembranous VSDs were found in 85.3 and 14.7%, respectively. Spontaneous closure of the VSDs occurred prenatally in 31/64 and 3/11 of fetuses with muscular VSD and perimembranous VSD, respectively. Spontaneous closure of the VSD by the age of 2 years occurred in 92.2 and 45.5% of cases with muscular and perimembranous VSDs respectively (p = 0.001). CONCLUSION: Isolated muscular VSDs usually close spontaneously during pregnancy or in the first 2 years of life and probably do not increase the risk for chromosomal aberrations. On the other hand, isolated perimembranous VSDs may need intervention following birth and may be associated with a chromosomal anomaly.
Authors: Ken Cheng; Hang Zhou; Fang Fu; Tingying Lei; Fucheng Li; Ruibin Huang; You Wang; Xin Yang; Ru Li; Dongzhi Li; Can Liao Journal: Front Cardiovasc Med Date: 2022-09-07