Natural history of ventricular septal defects in Nigerian Children

Abstract

Introduction: Ventricular septal defect (VSD) is a common congenital heart disease (CHD). Spontaneous closure of the VSD may occur depending on the type and size of defects. This study was carried out to determine the natural history of VSD in a group of Nigerian children. Subjects and Methods: Sixty one children diagnosed with VSD were prospectively studied till they were two years of age in a tertiary centre in Nigeria. They had regular two dimensional (2D) echocardiography evaluations for the VSD size and closure.
Results: Most of the patients were female 35 (57.4 %), the mean age at presentation was 11.2 ± 5.2 months while the commonest type of VSD was the perimembranous 39 (63.9%). Almost half 28 (45.9%) of the patients had spontaneous closure. Spontaneous closure rate was highest in muscular VSD (82.4%) and in the small sized defects (95.0%). Incidental presence of a murmur, absence of heart failure and bronchopneumonia were good clinical predictors of closure. Only 3(4.9%) patients had surgery abroad and 2 (3.3%) mortality was recorded in the entire series.
Conclusion: In conclusion, spontaneous closure readily occurs in small sized defects and muscular VSDs. Most patients with moderate to large VSDs are confined to long term medical management, highlighting the need for indigenous surgical capacity in Nigeria.