Evaluation of the clinical course of the patients with isolated ventricular septal defect followed up in Gaziantep University Faculty of Medicine Hospital

Objective: We aimed to evaluate the clinical course of the patients diagnosed with ventricular septal defect (VSD). Materials and Methods: The present study was conducted by evaluating the patients who were diagnosed with VSD in the Pediatric Cardiology Unit of Gaziantep University Faculty of Medicine Pediatrics Department and followed up in the control visits of outpatient clinics between January 2014-June 2017 retrospectively. In the study, the age at first diagnosis and gender of the patients, VSD types, VSD diameters, number of defects and interrelationships of these parameters, spontaneous closure, transcatheter or surgical closure, ratios of those on medical treatment and those followed up without medication were evaluated. Results: Three hundred thirty-one patients were included in the study. Of the patients, 159 (48%) were girl and 172 (52%) were male. A single defect was observed in 294 patients (88,8%) and multiple defects were detected in 37 patients (11,2%). Perimembranous VSD was detected in 261 (78,9%) of the patients and muscular VSD in 70 (21,1%) of them. The VSD diameter was found to be 2 mm or below in 64 patients (19,3%), 3-5 mm in 143 patients (43,2%), 6 mm and over in 124 patients (37,5%). Down syndrome was detected in 29 patients (8,8%). Left ventricular dilatation was observed in 89 (26,9%) patients and congestive heart failure (CHF) in 29 patients (8.8%). A spontaneous closure was observed in 25 of the patients (7,6%). Of them, 11 (44%) closed within the first three months while 10 (40%) closed within 4-12 months. Membranous septal aneurysm (MSA) accompanied 81 perimembranous VSDs (31%). Grade I tricuspid insufficiency (TI) was found in 135 patients (40,8%), grade II TI in 54 patients (16,3%), grade III TI in 15 patients (4,5%). Pulmonary artery pressure (PAP) was found to be normal in 248 cases (74,9%) whereas mild pulmonary hypertension (PHT) was identified in 24 cases (7,3%), moderate pulmonary hypertension in 32 cases (9,7%) and severe pulmonary hypertension in 27 cases (8,2%). Aortic ınsuffıency (AI) was found in 65 patients (%19,6). AVP and AY and also DSM has a relationship.It was determined that 102 patients (30,8%) were under follow-up without medication, 98 patients (29,6%) received only medical treatment, the transcatheter closure was performed in 67 patients (20,2%) and surgical closure was performed in 64 patients (19,3%). Conclusion: No association was noted between gender and defect type. It was observed that perimembranous VSD was detected more commonly, that MSA developed in one-third of those. The spontan closure rate is higher in musculer VSD. Most of spontan closure were observed within 12 months. The VSD diameter increased, the risk of CHF development increased and that there was a significant relationship between AI and AVP and also DSM. Key Words: Ventricular Septal Defect, Echocardiography, Clinical Course