High Rate Of Spontaneous Closure Research Articles

Multiple small fenestrations created during construction of the total cavopulmonary circulation: Subsequent course and spontaneous closure

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Bomb blast injuries to the ear: the London Bridge incident series.

Twelve patients who were treated for ear injuries at Guy's Hospital following the London Bridge bomb blast in February 1992 were reviewed. Among three there were four perforated eardrums, two of which closed spontaneously (50%). All three patients had a persistent mixed hearing loss. The remaining nine patients had acute sensorineural hearing loss and/or tinnitus only. Four of these had resolved completely by 4h, another one by 48h, and two by 4 weeks. Two patients had a residual high frequency hearing loss. In total, five patients (42%) have a persistent hearing loss. None of the patients suffered from balance problems. In summary, the ear is very susceptible to bomb blast injury, but there is a high rate of spontaneous closure of perforations and improvement of sensorineural hearing loss and tinnitus.

To be or not to be a VSD

This study confirmed the fact that a large majority of isolated VSDs (74%) detected in utero will spontaneously close. Spontaneous closure rates were higher in utero than those detected in infants or children. Isolated VSDs detected in utero did not contribute to fetal morbidity and mortality. There is no correlation between the size of the defect and the probability of closure of the defect. Because of the high spontaneous closure rate of VSDs in utero and the lack of increased morbidity, parental anxiety can be allayed or minimized. For these reasons, close follow-up in utero is not necessary, and reevaluation can be done at birth.

Atrial septal defects that present in infancy.

The diagnosis of isolated secundum atrial septal defect (ASD) in infancy is uncommon. We studied 26 infants with ASD confirmed at cardiac catheterization. Of these, nine were born prematurely, 15 presented with symptoms of congestive heart failure, and only three were noted to have the clinical features of an ASD in spite of large left to right shunts. All but two patients responded to medical management. Spontaneous closure of the ASD was documented in 39% (ten) of the patients at ages ranging from 2 to 8 years. Twelve patients underwent surgical closure at a mean age of 4 years. No variables at presentation were predictive of subsequent spontaneous closure. In view of the high rate of spontaneous closure and the success of medical therapy, most infants with symptomatic ASD may be managed medically, allowing sufficient time to observe whether spontaneous closure will occur.