Congenital Isolated Apical Ventricular Septal Defects

The diagnosis of apical ventricular septal defects is difficult and the ratio of spontaneous closure is not well known. At the Ankara University Pediatric Cardiology Department, between the years 1992-1 995, 20 patients were identified by colour-flow Doppler imaging as having a smail defect at the apical portion the ventricular septum. The age range was 1 days to 13 years. All patients were asymptomatic wi th normal telecardiograms and electrocardiograms. There was a grade 2-3 1 6, short or pansystolic murmur at the apex or closer to the apex of the heart, distal to the moderator band. These defects were difficult to image and required specific angulation of the transducer. Of the 15 patients who had follow-up examinations, 3 months to 3,5 years, there was spontaneous closure in five (33 % ). To our knowledge, this report is the largest series of isolared apical VSD. In our experience, color-flow imaging is more sensitive in detecting a smail apical VSD. Although the closure of apical VSD is not the rule, the prognosis is excellent.