Prospective monitoring of children with ventricular septal defect in the region of the Una-Sana Canton [Article in Bosnian]

Abstract

Objective - The aim of this study was to evaluate the natural history and outcome of disease in patients with ventricular septal defect (VSD) in respect to the association with other congenital heart diseases (CHD).

Material and methods - We analysed the medical documentation of patients with VSD at Department of Paediatrics in the Bihac Canton Hospital.The following was analysed: the number, size, location of defect, incidence of association with other CHD and Down’s Syndrom and also the history and outcome of disease.

Results I- n the period from January 1, 2003 to December 31, 2007 VSD was diagnosed in a total of 98 patients. An isolated VSD was registrated in 67.3% patients and in 32.6% cases was associated with other CHD (10.2 % with atrioseptal defect,9.1 % with cyanotic anomalies, 7.1% with pulmonic stenosis). Nine of the patients with Down’s syndrome had VSD. In 31 child with isolated VSD, the defect was localized in the muscular portion and 35 children had the defect in the perimembraneous portion. In 27 children with VSD associated with other CHD the defect was found in the perimembraneous portion and only in fi ve children in the muscular part. A large defect was present in 31 children, a medium size defect in 13 children and small defects were found in 54 children. Spontaneous closure of the defect was recorded in 14 patients, whilst cardiosurgical treatment was applied in 22 children. Seven children died and two of them developed fi xed pulmonary hypertension. Fifty-three children are still under monitoring.

Conclusion - According to our results, thanks to timely diagnosis and continous cardiological monitoring, the disease can be controlled in spite of the limited cardiosurgical resources in our conditions.