{"id":"90c59b79f92c","type":"article","url":"https://hartvaat.nl/2026/03/31/volwassenen-met-een-ventrikelseptumdefect-hebben-drie-keer-hogere-sterfte-zweeds/","title":"Volwassenen met een ventrikelseptumdefect hebben drie keer hogere sterfte (Zweeds register)","title_en":"Mortality in patients with ventricular septal defect in Sweden: a national register study","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Open Heart","doi":"http://openheart.bmj.com/cgi/content/short/13/1/e004098?rss=1","source_url":"https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004098?rss=1","authors":["Lundberg","P.","Fedchenko","M.","Giang","K. W.","Eckerström","F.","Eriksson","P.","Dellborg","M.","Mandalenakis","Z."],"significance":6,"published":"2026-03-31","source_date":"2026-03-31","image":"","kennis":["https://hartvaat.nl/kennis/kleplijden/aortastenose/","https://hartvaat.nl/kennis/kleplijden/mitralisregurgitatie/"],"congress":"","summary_en":"Ventricular septal defect (VSD) is the most common congenital heart defect, but much about long-term prognosis is unclear. In this Swedish register study, 22,855 VSD patients (born 1970-2017) were compared with ten matched controls without congenital heart disease per patient; patients with complex congenital disease were excluded. Mortality was elevated versus controls: hazard ratio 6.8 at ages 0-17 and 3.1 above age 18. Even in isolated, non-syndromic VSD, mortality remained elevated regardless of whether the defect had been repaired in childhood. Mortality was highest in cohorts with syndromes and associated valvular lesions. Adults with VSD thus have more than threefold higher mortality than controls — arguing for continued cardiology follow-up, even after repair.","created":"2026-07-03T10:32:20Z","updated":"2026-07-03T13:31:17Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Het ventrikelseptumdefect (VSD) is de meest voorkomende aangeboren hartafwijking, maar over de langetermijnprognose is veel onduidelijk. In dit Zweedse registeronderzoek werden 22.855 VSD-patiënten (geboren 1970-2017) vergeleken met tien gematchte controles zonder aangeboren hartafwijking per patiënt; patiënten met complexe aangeboren afwijkingen werden uitgesloten. De sterfte was verhoogd ten opzichte van controles: hazard ratio 6,8 op de leeftijd 0-17 jaar en 3,1 boven de 18 jaar. Ook bij geïsoleerd, niet-syndromaal VSD bleef de sterfte verhoogd, ongeacht of het defect in de jeugd was gesloten. De sterfte was het hoogst in cohorten met syndromen en bijkomende klepafwijkingen. Volwassenen met een VSD hebben dus een ruim drie keer hogere sterfte dan controles — wat pleit voor blijvende cardiologische follow-up, ook na correctie.","abstract_original":"Objectives\n

Ventricular septal defect (VSD) is the most common congenital heart defect. Much remains unclear about the long-term prognosis for VSD patients. This study aimed to investigate the all-cause and cardiovascular mortality in patients with VSD compared with controls without congenital heart disease in Sweden.

\n\nMethods\n

Swedish National Patient Register was used to identify all VSD patients born between 1970 and 2017. Mortality data were collected from the Swedish National Cause of Death register. Patients with associated complex congenital heart disease or non-congenital VSD were excluded. The VSD cases were matched by age and sex with 10 controls without congenital heart disease for each case.

\n\nResults\n

A total of 22 855 VSD patients were included. The hazard of death for the entire VSD cohort, including patients with syndromes and associated non-complex congenital cardiac lesions, was increased compared with matched controls without congenital heart disease, with a HR of 6.8 (95% CI 6.1 to 7.6) for ages 0–17 years and HR of 3.1 (95% CI 2.5 to 4.0) for ages >18 years, during a mean follow-up of 14.3 years (±11.1). In isolated, non-syndromic VSD, the hazard of death was still elevated compared with controls, regardless of whether the VSD had been repaired in childhood or not. The HR for death for unrepaired VSDs was 4.8 (95% CI 4.1 to 5.6) for ages 0–17 years and 2.1 (95% CI 1.5 to 3.0) for ages >18 years and for VSDs repaired before 18 years of age HR for death was 2.9 (95% CI 1.2 to 7.1) for ages 0–17 years and 8.2 (95% CI 2.2 to 30.4) for ages >18 years.

\n\nConclusions\n

Mortality rates were three times higher in adult VSD patients compared with matched controls. Mortality risk was highest in VSD cohorts that included patients with syndromes and congenital valvular lesions, highlighting VSD patients at extra risk of adverse outcomes.

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