02154nam 2200205 n 450 TD13052171TDMAGDIG20190501d2009------k--ita-50----ba Natural and Unnatural History of Isolated Ventricular Septal Defects in a Paediatric Population: A Longitudinal Retrospective StudyTesi di dottoratoIn relazione con http://paduaresearch.cab.unipd.it/1511/tesi di dottoratoMED/38 Pediatria generale e specialisticaThis study shows the rate of spontaneous closure of various types of ventricular septal defects over time, 519 patients with VSD had been studied and followed by time, the spontaneous closure(SC) had been documented in 80% (185/232) of all muscular defects, in 22%(62/279) of perimembranous defects, one case(1/8, 12%) of subpolmonary defects. the SC had been registered in 19 of patients by age of 6 months, in 50% of cases by age between 1-2 years , in 77 % of patients between 2-4 years , and in 97 % by age between 6 and 10 years. in patients without congestive heart failure(CHF), the rate of SC was 50%, the SC had been registered in (12/74) 16% of patients with CHF. this observation suggest un conservative attitude in the first months of life, unless a pulmonary hypertension is developed. surgery is quite safe ( we haven’t considered the per operative mortality), although sever complications like complete a-v block was verified in 2% of cases, VSD residual in 14% of cases with the necessity of re-intervention in 1% of cases , we contend that the SC, probably, occur by the growth of muscular septum around the defect, this explain why muscular defects close before membranous VSD, like we have demonstrated in our study. application/pdfMED/38Pediatria generale e specialisticaTDRAhmad, AmmarITIT-FI0098http://memoria.depositolegale.it/*/http://paduaresearch.cab.unipd.it/1511/1/Copia_finale_di_tesi_da_stampare_corretta%5B1%5D.pdfhttp://paduaresearch.cab.unipd.it/1511/1/Copia_finale_di_tesi_da_stampare_corretta%5B1%5D.pdfCFTDTD