What is the clinical evidence from this study?

Study design: Observational. Population: Ventricular septal defects (n=14). Intervention: Conservative management. Primary outcome: Presence of left-to-right shunt on subsequent cardiac catheterization.

What question did this study set out to answer?

To document and characterize the spontaneous functional closure of ventricular septal defects in pediatric patients using serial hemodynamic and angiocardiographic assessments.

June 1, 1963PEDIATRICS

Spontaneous Functional Closure of Ventricular Septal Defects in Fourteen Children Demonstrated by Serial Cardiac Catheterizations and Angiocardiography

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Key result

Spontaneous functional closure of ventricular septal defects was observed in 14 children over 13 months to 6 years, supporting a conservative approach to surgical intervention in infants.

Why the study?

Does conservative management allow for spontaneous functional closure of ventricular septal defects in children?

Population

14 children with ventricular septal defects and an initial left-to-right shunt at the ventricular level…

Design

Case_series

Follow-up

13 months to 6 years

Authors

MAMagnus H. AgustssonSwedish American Hospital RAR A ArcillaUniversity of Illinois Chicago JBJ.P. BicoffSaint Francis University

Discussion

Member takes

Implication

Should not yet change VSD management; leaves open the role of spontaneous closure in infants.

Key Points

To document and characterize the spontaneous functional closure of ventricular septal defects in pediatric patients using serial hemodynamic and angiocardiographic assessments.
Evaluated 14 pediatric patients (N=14) diagnosed with ventricular septal defects who initially presented with left-to-right shunts.
Performed baseline and follow-up cardiac catheterizations, oxymetry, selective dye dilution, and left ventricular angiocardiography over follow-up intervals of 13 months to 6 years.
Holosystolic murmurs completely resolved in 7 of 14 patients (replaced by basal ejection murmurs in 5) and decreased in intensity in the remaining 7 patients.
Left-to-right shunting at the ventricular level completely resolved on follow-up oximetry in all 14 patients, with minimal residual shunts detectable only by selective dye dilution and angiocardiography in 6 patients.

Study Design

Type

Observational (n=14)

Structured PICO

Does conservative management allow for spontaneous functional closure of ventricular septal defects in children?

Population

14 children with ventricular septal defects evaluated by serial cardiac catheterizations over 13 months to 6 years.

Exposure

Conservative management (observation)

Outcome

Spontaneous functional closure of ventricular septal defect (absence of left-to-right shunt on oxygen saturation data)surrogate

Spontaneous closure of ventricular septal defects occurs in some children, supporting a conservative approach to surgical intervention in infants.

Cite This Study

Agustsson et al. (1963) conducted an observational in Ventricular septal defects (n=14). Conservative management was evaluated on Presence of left-to-right shunt on subsequent cardiac catheterization. Spontaneous functional closure of ventricular septal defects was observed in 14 children over 13 months to 6 years, supporting a conservative approach to surgical intervention in infants.

synapsesocial.com/papers/6a8f69146876bb4413ff5c38 https://doi.org/10.1542/peds.31.6.958

Topics

Congenital heart disease adults

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Spontaneous Functional Closure of Ventricular Septal Defects in Fourteen Children Demonstrated by Serial Cardiac Catheterizations and Angiocardiography

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Spontaneous Functional Closure of Ventricular Septal Defects in Fourteen Children Demonstrated by Serial Cardiac Catheterizations and Angiocardiography

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

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Topics

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