Spontaneous Functional Closure of Symptomatic Atrial Septal Defects

Abstract

SPONTANEOUS closure of ventricular septal defects, which was first postulated on the basis of changing clinical findings in 1918^{1 2 3} and first demonstrated by serial cardiac-catheterization studies in 1957,⁴ has now been documented as occurring during infancy,^{5 6 7} childhood,^{7 8 9} and adulthood.^{10 11 12 13 14} Medical management of ventricular septal defects during infancy is usually recommended since even large defects associated with large left-to-right shunts and congestive heart failure have been observed to undergo spontaneous functional closure.^{4 5 6 7 , 15} Delayed spontaneous closure of patent ductus arteriosus has also been reported in premature babies,^{16 , 17} children^{18 19 20 21 22 23} and adults.^{20 , 24} In premature babies with large ductal shunts and congestive heart failure it . . .