Authors : Hanifa.S.Alrabte; Asma Berfad; Laila T Sabei; Nafisa Abushiba

Volume/Issue : Volume 9 - 2024, Issue 5 - May

Google Scholar : https://tinyurl.com/33upwtrw

Scribd : https://tinyurl.com/2t6kh3ze

DOI : https://doi.org/10.38124/ijisrt/IJISRT24MAY981

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Abstract : Introduction and Objectives: Ventricular septal defect (VSD) is the most common congenital heart diseases, it accounts 40%. This study carried out to describe the epidemiological characters and clinical presentation of patients with VSD in Western and Southern Libya, and to evaluate spontaneous versus surgical closure in different types.  Patients and Methods It is hospital case series study conducted by reviewing the medical records of 1092 patients followed at cardiology outpatient department (OPD) of Tripoli Children Hospital from 1996 through 2009, the data abstracted from medical records and filed in a worked sheet, Excel and SPSS software used to analyze the data.  Results We identified 1092 patients. The results revealed that 30.9% diagnosed during the first month, and 49.7% from1 to 12 months. From 1092 patients; 50.8% have peri- membranous VSD, 18.8% muscular, and 13% having an apical type. 97.2% of males have peri-membranous VSD where muscular and apical seen more in female, p value = 0.001. Cardiac murmur is the common presenting sign 61.3%, 9.3% have feature of Down syndrome. Positive Family history of CHD in 9.9% with significant relationship between family history and type of VSD (peri- membranous type), P value = 0.001. Small VSDs accounts 66.9%, large VSDs 16.1%, followed by medium size VSD 11.8% of cases. Patients with large VSDs more prone for hospital admission as 101 (57.4%) from 176 patients were admitted to hospital, followed by moderate size (45%), P value = 0.001. 70.3% of patients with large VSD need either medical or surgical treatment, P value = 0.001. Spontaneous closure seen in 17%, 0.6% died, while 41.9% still on follow up. Muscular VSD shows the highest tendency for spontaneous closer as 72% closed by the age of 2 years.  Conclusion We conclude that peri- membranous VSD is the most common type. Two thirds of patients had been diagnosed in the first year of life. Big defects and some of moderate VSDs need either medical or surgical treatment. Spontaneous closer is usually seen in the first 2 years of life.  Recommendations We highly recommend for further multi-center study all over the country to get reliable data on the prevalence of congenital heart diseases and the incidence of ventricular septal defect in our population.

Keywords : Epidemiology, Infant, Children, Ventricular Septal Defect, Libya.

References :

1. Moss and Adams` Heart Disease in infant, Children, and Adolescents including the fetus and young Adults, eighth edition.
2. Penny DJ, Vick GW. Ventricular septal defect. Lancet. 2011; 377:11031112. Doi: 10.1016/S0140-6736(10)61339-6. [PubMed] [CrossRef] [Google Scholar]
3. Wael Dakkak, Tony.l.Oliver;Ventriculare septal defect, lsat update May/10 2022.
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):1298–1299. Doi: 10.1016/0735-1097(89)90431-2. [PubMed] [CrossRef] [Google Scholar].
5. Spicer DE, Hsu HH, Co-Vu J, Anderson RH, Fricker FJ. Ventricular septal defect. Orphanet J Rare Dis. 2014; 9:144. Doi: 10.1186/s13023-014-0144-2. [PMC free article] [PubMed] [CrossRef] [Google Scholar].
6. Williams LJ, Correa A, Rasmussen S. Maternal lifestyle factors and risk for ventricular septal defects. Birth Defects Res A Clin Mol Teratol. 2004;70(2):59–64. Doi: 10.1002/bdra.10145. [PubMed] [CrossRef] [Google Scholar].
7. Backer CL, Winters RC, Zales VR, et al. The restrictive ventricular septal defect: how small is too small to close? Ann Thorac Surg. 1993; 56:1014. Doi: 10.1016/0003-4975(95)90006-3. [PubMed] [CrossRef] [Google Scholar].
8. Roos-Hesselink JW, Meijboom FJ, Spitaels SE, et al. Outcome of patients after surgical closure of ventricular septal defect at young age: longitudinal follow-up of 22-34 years. Eur Heart J. 2004; 25:1057. Doi: 10.1016/j.ehj.2004.04.012. [PubMed] [CrossRef] [Google Scholar].
9. Thanopoulos BD, Tsaousis GS, Konstadopoulou GN, et al. Transcatheter closure of muscular ventricular septal defects with the Amplatzer ventricular septal defect  cclude: initial clinical applications in children. J Am Coll Cardiol. 1999; 33:1395–1399. Doi: 10.1016/S0735-1097(99)00011-X. [PubMed] [CrossRef] [Google Scholar].
10. Hijazi ZM, Hakim F, Al-Fadley F, et al. Transcatheter closure of single muscular ventricular septal defects using the Amplatzer muscular VSD  cclude: initial results and technical considerations. Catheter Cardiovasc Interv. 2000; 49:167–170. Doi: 10.1002/(SICI)1522-726X (200002)49:2<167: AID-CCD11>3.0.CO;2-S. [PubMed] [CrossRef] [Google Scholar].
11. Thanopoulos BD, Rigby ML. Outcome of  cclude heter closure of muscular ventricular septal defects with the Amplatzer ventricular septal defect  cclude. Heart. 2005; 91:513. Doi: 10.1136/hrt.2004.035535. [PMC free article] [PubMed] [CrossRef] [Google Scholar].
12. Carminati M, Butera G, Chessa M, et al. Transcatheter closure of congenital ventricular septal defect with Amplatzer septal occluders. Am J Cardiol. 2005; 96:52L. doi: 10.1016/j.amjcard.2005.09.068. [PubMed] [CrossRef] [Google Scholar].
13. Oweis, Nabeh et al. Patterns of congenital heart disease in Northern Jordan. Jordan Medical Journal 2006; 40 (4): 262-265 (40 ref.).
14. Wilson E Sadoh, MB BS, FWACP Paediatric Cardiology Unit, Department of Child Health, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.
15. Erdem S, Ozbarlas N, Küçükosmanoğlu O, Poyrazoğlu H, Salih OK (2012) [Long term follow-up of 799 children with isolated ventricular septal defects]. Turk Kardiyol Dern Ars 40: 22-25.
16. ALMAWAZINI, Abdulmajid M1; AL GHAMDI, Ali S1; GHAMDI, Ahmed H1; GHAMD, Jameel. Review of ventricular septal defect in South Western Saudi ArabiaSaudi medical journal. 2012, Vol 33, Num 8, pp 910-911, 2 p; ref: 4 ref CODEN SAMJDI, ISS.
17. Yung xu, Jinxiany liu, Jinghuo wang, Minlia, Sirui yang;Int J clin Exp Pathol;2015,8(5),5614-5623;Factors influencing the spontaneous closure of ventricular septal defect in infants.