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Review of ventricular septal defect in south western Saudi Arabia.

V entricular septal defect (VSD) is defined as a structural abnormality of the heart; defect in any portion of the ventricular septum with blood flow at the level of ventricles through this defect. It accounts 25% of congenital heart disease; 1 and remains one of the major causes of morbidity. 2 Ventricular septal defect is the most common lesion of congenital heart disease worldwide, 3 with a prevalence rate of 24% in Oman and 57.4% in Australia. Few studies in Saudi Arabia have been reported. Previous reports were as follows: 3 The aim of this study is to demonstrate the magnitude of VSD, the most common type and size, correlation with gender, spontaneous versus surgical closure in muscular and membranous type, and the role of close follow up in morbidity and mortality. This is a hospital based, prospective cross-sectional study. The study included all patients aged one day until 12 years with cardiac findings referred to the Pediatric Cardiology Unit, King Fahad Hospital at Al-Baha, Kingdom of Saudi Arabia from April 2005 to December 2011. The study was approved by the ethical committee of the hospital and the patient consent was not obtained due to no interventions or procedures were carried out. A computer based software program was established to register all cases. All patients were examined clinically, underwent chest x-ray, and electrocardiogram. The diagnosis of all patients was confirmed by echocardiography (Philips IE33 echocardiography machine, Philips, Bothel, WA, USA). For sedation, oral chloral hydrate 50mg/kg body weight or IV medazolam 0.15 mg/kg was used. The echocardiography examination was conducted using M-mode, 2-dimensional, pulse, and continuous wave Doppler, and colored Doppler echocardiogram. Regular follow up was carried out every 6 months for stable patient, and every 3 months for symptomatic patients in all types. Two-dimensional echocardiographic pictures were recorded in the standard parasternal long axis, short axis, apical 4 and 5 chamber, subcostal and suprasternal views. The type, size, the severity of the shunt, and biventricular function were analyzed according to the guideline of American Society of Echocardiography. Isolated VSD was considered in this study, but the defect associated with other congenital heart disease were excluded. Ventricular septal defect constitutes an important group of congenital heart disease that leads to great morbidity and low mortality in children. We found that early diagnosis using echocardiography with close observation and regular follow up decrease the morbidity significantly and make the mortality decrease. …