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Incidence and natural history of neonatal isolated ventricular septal defects: Do we know everything? A 6-year single-center Italian experience follow-up

Alberto Cresti1, Raffaele Giordano2, Martin Koestenberger3, Isabella Spadoni4, Marco Scalese5, Ugo Limbruno1, Susanna Falorini6, Stefania Stefanelli1, Andrea Picchi1, Francesco De Sensi1, Angela Malandrino7, Massimiliano Cantinotti4,5
1 Department of Cardiology, Misericordia Hospital, Grosseto, Italy
2 Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
3 Division of Pediatric Cardiology, Medical University of Graz, Graz, Austria
4 Fondazione G. Monasterio CNR-Regione Toscana, Massa and Pisa, Italy
5 Institute of Clinical Physiology, Pisa, Italy
6 Department of Pediatrics, Misericordia Hospital, Grosseto, Italy
7 Department of Cardiology, Santa Maria alle Scotte Hospital, University of Siena, Siena, Italy
* Corresponding Author: Raffaele Giordano, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy. Email:

Congenital Heart Disease 2018, 13(1), 105-112. https://doi.org/10.1111/chd.12528

Abstract

Background: Despite ventricular septal defects (VSDs) are the most common congenital heart diseases (CHDs) in the neonatal period, their incidence and natural history are still debated and their follow-up and management strategies remain controversial. Our aim was to evaluate the incidence and natural history of isolated VSDs.
Methods: From January 1996 to December 2015 all neonates with a CHD suspicion were referred to the Cardiological Department of Grosseto Misericordia Hospital. Only newborns with confirmed isolated VSD were enrolled in this study and followed for 6 years.
Results: Our 343 newborns with an isolated VSD (incidence of 10.45/1000/births) account for 64% of all detected CHDs. VSDs location were as follows: muscular (73.8%), perimembranous (11.3%), inlet (1%), and outlet (0.8%). Of the located VSDs, 90% were small, 7.5% moderate, and 2.5% large, respectively. Spontaneous closure was observed in 96 (29.2%) of the VSD patients at 6-month, 198 (60.2%) at 1-year, 261 (79.3%) at 2-year, and in 302 (91.8%) at 6-year follow-up. Risk factors for defect persistence were a perimembranous location (P = .001; HR: 0.508, CI: 0.342-0.755), detection of multiple defects (P = .043; HR: 0.728, CI: 0.536-0.990), and male gender (P < .048; HR: 0.783, CI: 0.615-0.998), respectively.
Conclusions: We here provide an incidence and natural history of neonatal isolated VSDs in a neonatal Caucasian population. These data may be useful for the development of expert consensus/standard recommendation guidelines for the follow-up and VSD management, data that are currently lacking.

Keywords

children, echocardiography, neonates, ventricular septal defects

Cite This Article

Cresti, A., Giordano, R., Koestenberger, M., Spadoni, I., Scalese, M. et al. (2018). Incidence and natural history of neonatal isolated ventricular septal defects: Do we know everything? A 6-year single-center Italian experience follow-up. Congenital Heart Disease, 13(1), 105–112.



This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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