Document Type : Original Article

Authors

1 Assistant Professor, Cardiovascular Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

2 Associated Professor, Cardiovascular Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

3 School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

4 PhD in Nursing, Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

5 Assistant Professor, Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

6 Student of Medicine (MD), School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background and aims: Since ventricular septal defect (VSD) is the most common congenital heart disease, this study aimed to investigate its prevalence, characteristics, and associated diseases in a referral children’s heart clinic in south of Iran.
Methods: In this cross-sectional study that was conducted based on the databases of children with heart diseases, patients under 18 years of age referring to Imam Reza clinic were examined. All patients with at least one record of VSD in echocardiography during 2016-2017 were included. Demographic and echocardiographic characteristics including size of VSD, shunt gradient, pulmonary hypertension (PH), aortic regurgitation, and associated cyanotic and acyanotic defects were analyzed.
Results: The prevalence of VSD found in 7458 echocardiography records was 12%, the median age of patients was 9.3, and the male/female ratio was 1.08. The perimembranous VSDs were determined to be the most common types of VSD. The most common associated complication with VSD was detected to be PH followed by aortic regurgitation. Sub-pulmonic showed the highest association with aortic failure. Atrial septal defect and tetralogy of Fallot (TOF) were the most common acyanotic and cyanotic heart defects, respectively. Only 0.5% of the patients had Eisenmenger syndrome.
Conclusion: Fortunately, the prevalence of the complication of VSD was not high in south of Iran, and the number of Eisenmenger syndrome was low. The types of VSD and the number of its complications identified in study population were similar to those in other populations.

Keywords

1.Huang SY, Chao AS, Kao CC, Lin CH, Hsieh CC. The outcome of prenatally diagnosed isolated fetal ventricular septal defect. J Med Ultrasound. 2017;25(2):71-5. doi: 10.1016/j.jmu.2017.05.005. 
2.Soto B, Becker AE, Moulaert AJ, Lie JT, Anderson RH. Classification of ventricular septal defects. Br Heart J. 1980;43(3):332-43. doi: 10.1136/hrt.43.3.332. 
3.Gumbiner C, Takao A. Ventricular septal defect. In: Garson A, Bricker JT, Neish SR, eds. The Science and Practice of Pediatric Cardiology. Philadelphia: Williams & Wilkins; 1998. p. 1119-40. 
4.Van Praagh R, Geva T, Kreutzer J. Ventricular septal defects: how shall we describe, name and classify them? J Am Coll Cardiol. 1989;14(5):1298-9. doi: 10.1016/0735- 1097(89)90431-2. 
5.Penny DJ, Vick GW 3rd. Ventricular septal defect. Lancet. 2011;377(9771):1103-12. doi: 10.1016/s0140- 6736(10)61339-6. 
6.Miller RH, Schiebler GL, Grumbar P, Krovetz LJ. Relation of hemodynamics to height and weight percentiles in children with ventricular septal defects. Am Heart J. 1969;78(4):523- 9. doi: 10.1016/0002-8703(69)90487-6. 
7.Fyler DC, Rudolph AM, Wittenborg MH, Nadas AS. Ventricular septal defect in infants and children; a correlation of clinical, physiologic, and autopsy data. Circulation. 1958;18(5):833-51. doi: 10.1161/01.cir.18.5.833. 
8.Perloff JK, Marelli A. Perloff ’s Clinical Recognition of Congenital Heart Disease. 6th ed. Philadelphia: Saunders, 2012. p. 576. 
9.Evans JR, Rowe RD, Keith JD. Spontaneous closure of ventricular septal defects. Circulation. 1960;22:1044- 54. doi: 10.1161/01.cir.22.6.1044. 
10.Behjati-Ardakani M, Soltani MH, Dehghani- Firoozabadi R. The clinical course of ventricular septal defect. J Mazandaran Univ Med Sci. 2011;21(85):159- 164. [Persian]. 
11.Shahid NA, Hyder SN, Hasan A. Frequency of types of ventricular septal defect in Cardiology Department of the Children Hospital & ICH, Lahore. Pak J Med Health Sci. 2016;10(3):909-12. 
12.Amel-Shahbaz S, Behjati-Ardakani M, Namayandeh SM, Vafaeenasab M, Andishmand A, Moghimi S, et al. The epidemiological aspects of congenital heart disease in central and southern district of Iran. Adv Biomed Res. 2014;3:233. doi: 10.4103/2277- 9175.145732. 
13.Nazari P, Davoodi M, Faramarzi M, Bahadoram M, Dorestan N. Prevalence of congenital heart disease: a single center experience in southwestern of Iran. Glob J Health Sci. 2016;8(10):56421. doi: 10.5539/gjhs. v8n10p288. 
14.Zhao QM, Liu F, Wu L, Ma XJ, Niu C, Huang GY. Prevalence of congenital heart disease at live birth in China. J Pediatr. 2019;204:53-8. doi: 10.1016/j. jpeds.2018.08.040. 
15.Chaudhry TA, Younas M, Baig A. Ventricular septal defect and associated complications. J Pak Med Assoc. 2011 Oct;61(10):1001-4. 
16.Pate N, Jawed S, Nigar N, Junaid F, Wadood AA, Abdullah F. Frequency and pattern of congenital heart defects in a tertiary care cardiac hospital of Karachi. Pak J Med Sci. 2016;32(1):79-84. doi: 10.12669/ pjms.321.9029. 
17.Mostefa-Kara M, Houyel L, Bonnet D. Anatomy of the ventricular septal defect in congenital heart defects: a random association? Orphanet J Rare Dis. 2018;13(1):118. doi: 10.1186/s13023-018-0861-z.