The natural history of ventricular septal defects in the south-western region of Saudi Arabia

AIM: To determine the natural history and spontaneous closure (SpC) of ventricular septal defect (VSD) in a cohort of patients. METHODS: Using echocardiography, 86 patients with VSD were followed up for 1-168 mths (mean 66.3, SD 46.0). RESULTS: Mean age at diagnosis was 14 mths, 26 patients were diagnosed at < or = 1 mth (group 1) and 60 later (group 2). Types of VSD were: peri-membranous (PM-VSD) 67.4%, muscular (MU-VSD) 19.8%, inlet 7% and subpulmonary/subarterial 5.8%. SpC occurred in 16.3% of the whole group, 34.6% of group 1 and 8.3% of group 2 (p = 0.002). SpC occurred only in PM-VSDs (19%) and in MU-VSDs (17.6%). It occurred in 26.5% of the small VSDs and in none of the large VSDs. One patient (1.2%) developed endocarditis and another pulmonary vascular disease. CONCLUSIONS: PM-VSD was the most common type of VSD. SpC is age-dependent, occurring mainly in PM and MU-VSDs. SpC of a large VSD is unusual.