International Journal of Cardiology 150 (2011) e43 – e45 www.elsevier.com/locate/ijcard
Letter to the Editor
A case of spontaneous closure of a muscular ventricular septal defect Domenico Tulino a , Giuseppe Dattilo b , Viviana Tulino c , Annalisa Lamari d , Filippo Marte b , Salvatore Patanè b,⁎ a Operative Unit of Cardiology, Hospital “G. Jazzolino” Vibo Valentia, Italy Cardiologia Nuovo Presidio Ospedaliero Cutroni Zodda-Barcellona P.d.G (Me), AUSL5 Messina, Italy c Department of Pediatrics, Neonatal ICU, University Hospital of Messina, Italy Clinical and Experimental Department of Medicine and Pharmacology, University of Messina, Messina, Italy b
d
Received 3 February 2009; accepted 27 February 2009 Available online 25 March 2009
Abstract Ventricular septal defects can occur as part of more congenital cardiac malformations or as an isolate finding. Surgical closure, transcatheter occlusion and spontaneous closure have been reported. We present a case of spontaneous closure of a muscular ventricular septal defect. This case focuses attention on spontaneous closure of a muscular ventricular septal defect. © 2009 Elsevier Ireland Ltd. All rights reserved. Keywords: Cardiac malformations; Closure; Ventricular septal defect
1. Case report Ventricular septal defects [1–8] can occur as part of more congenital cardiac malformations or as an isolate finding. Surgical closure, transcatheter occlusion [9]and spontaneous closure [10] have been reported. We present a case of spontaneous closure of a muscular ventricular septal defect. A female Italian infant was referred at the age of 3 months to the Cardiology Unit for a cardiovascular check-up. A normal increase in height and weight was reported. An olosystolic murmur (grade 2–3/6) was present. A bidimensional transthoracic echocardiography revealed a muscular ventricular septal defect with a minimal left-to-right shunt (Fig. 1 Panels A and B). At the age of 5 months and 15 days, a bidimensional transthoracic echocardiography showed the muscular ventricular septal defect with a smaller left-to-right shunt (Fig. 2 Panels A and B). At the age of 1 year, a ⁎ Corresponding author. Cardiologia Nuovo Presidio Ospedaliero Cutroni Zodda-Barcellona P.d.G (Me) AUSL5 Messina; Via Cattafi 98051 Barcellona Pozzo di Gotto, Messina, Italy. Tel.: +39 3402783962. E-mail address:
[email protected] (S. Patanè). 0167-5273/$ - see front matter © 2009 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2009.02.038
bidimensional transthoracic echocardiography showed the absence of the muscular ventricular septal defect (Fig. 2 Panels B and C). The absence of the muscular ventricular septal defect was confirmed at 1 year and 6 months of age by a bidimensional transthoracic echocardiography. This case focuses attention on spontaneous closure of the muscular ventricular septal defect. Acknowledgement The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology [11]. References [1] Patanè S, Marte F, Di Bella G, Fazio G, Villari SA. Revelation of an asymptomatic ventricular septal defect in elderly patient before a surgical intervention. Int J Cardiol Jan 7 2009 [Electronic publication ahead of print]. [2] Patanè S, Marte F, Di Bella G. Transposition of the great arteries. Int J Cardiol Nov 28 2008;130(3):e98–9 Electronic publication 2007 Sep 19.
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D. Tulino et al. / International Journal of Cardiology 150 (2011) e43–e45 [4] Rahko PS. Doppler echocardiographic evaluation of ventricular septal defects in adults. Echocardiography Sep 1993;10(5):517–31 Review. [5] Dattilo G,Tulino V, Tulino D, Lamari A, Marte F, Patanè S. Interatrial defect,ventricular septal defect and patent ductus arteriosus in a 2-dayold newborn infant. Int J Cardiol Feb 23 2009 [Electronic publication ahead of print]. [6] Chessa M, Butera G, Negura D, Bussadori C, Giamberti A, Fesslova V, Carminati M. Transcatheter closure of congenital ventricular septal defects in adult: MID-term results and complications. Int J Cardiol 2009 Mar 20;133(1):70–3 Electronic publication 2008 Jan 29. [7] Taborosi B, Tödt-Pingel I, Kayser G, Dittrich S. A rare case of aortic coarctation and ventricular septal defect combined with alveolar capillary dysplasia. Pediatr Cardiol Jul–Aug 2007;28(4):319–23 Electronic publication 2007 May 25. Review. [8] Minette MS, Sahn DJ. Ventricular septal defects. Circulation Nov 14 2006;114(20):2190–7 Review. Erratum in: Circulation. 2007 Feb 20;115(7):e205. [9] Dehghani M, Sharifkazemi MB, Aslani A, Hoseini E, Samin MM. Closure of a muscular ventricular septal defect using the Amplatzer ventricular occluder. Arch Iran Med Oct 2007;10(4):543–5. [10] Garne E. Atrial and ventricular septal defects — epidemiology and spontaneous closure. J Matern Fetal Neonatal Med May 2006;19(5): 271–6. [11] Coats AJ. Ethical authorship and publishing. Int J Cardiol 2009;131: 149–50.
Fig. 1. Panel A, transthoracic echocardiography, long axis parasternal view, the muscular ventricular septal defect with a minimal left-to-right shunt. Panel B, transthoracic echocardiography, 5 chambers apical view, the muscular ventricular septal defect with a minimal left-to-right shunt. [3] Patanè S, Marte F, Di Bella G. Echocardiographic diagnosis of syndrome of left ventricular–right atrial shunt (Gerbode defect). Int J Cardiol Aug 29 2008;128(3):e85–6 Electronic publication 2007 Aug 8.
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Fig. 2. Panel A, transthoracic echocardiography, off-axis 5 chambers apical view, the muscular ventricular septal defect with a smaller left-to-right shunt. Panel B, transthoracic echocardiography, off-axis 4 chambers apical view, the muscular ventricular septal defect with a smaller left-to-right shunt. Panel C, transthoracic echocardiography, off-axis 5 chambers apical view, absence of muscular ventricular septal defect. Panel C, transthoracic echocardiography, 4 chambers apical view, absence of muscular ventricular septal defect.
