Isolated ventricular septal defects demonstrated by fetal echocardiography: prenatal course and postnatal outcome

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.

Keywords:

• Echocardiography
• fetus
• outcome
• prenatal
• ultrasound
• ventricular septal defect
• VSD

Ethical approval

This is a retrospective study approved by the Wolfson Medical Center and Maccabi Health Services ethical committees. There was no need for informed consent due to the retrospective nature of the as waived by the ethical committees that approved the study. All participants are human.

Author contributions

Liat Gindes and Alona Raucher wrote the main manuscript text, Alona Raucher and Akiva Tamir did the echocardiography, Amichay Sheffy collected and arrange the data. Yossi Mizrachi assisted with the statistics. Mordechai Shohat, Rachel Berger and Dorit Lev did the genetic investigation. All authors reviewed the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.