{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T18:10:29Z","timestamp":1774980629810,"version":"3.50.1"},"reference-count":20,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"unspecified","delay-in-days":89,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Swedish state, ALF agreement","award":["grant numbers: 236611, 917361"],"award-info":[{"award-number":["grant numbers: 236611, 917361"]}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["VRREG 2019-00193, VR 2018-02527"],"award-info":[{"award-number":["VRREG 2019-00193, VR 2018-02527"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2026,3,17]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u201317 years and HR of 3.1 (95% CI 2.5 to 4.0) for ages &gt;18 years, during a mean follow-up of 14.3 years (\u00b111.1). 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\u201317 years and 2.1 (95% CI 1.5 to 3.0) for ages &gt;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\u201317 years and 8.2 (95% CI 2.2 to 30.4) for ages &gt;18 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2026-004098","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T17:35:24Z","timestamp":1774978524000},"page":"e004098","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Mortality in patients with ventricular septal defect in Sweden: a national register study"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8545-0104","authenticated-orcid":false,"given":"Per","family":"Lundberg","sequence":"first","affiliation":[{"name":"Department of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden"},{"name":"Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Fedchenko","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden"},{"name":"Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kok Wai","family":"Giang","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden"},{"name":"Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3295-2930","authenticated-orcid":false,"given":"Filip","family":"Eckerstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden"},{"name":"Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Eriksson","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden"},{"name":"Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikael","family":"Dellborg","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zacharias","family":"Mandalenakis","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden"},{"name":"Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"2026033110351421000_13.1.e004098.1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz009"},{"key":"2026033110351421000_13.1.e004098.2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwac227"},{"key":"2026033110351421000_13.1.e004098.3","first-page":"516","article-title":"A review of spontaneous closure of ventricular septal defect","volume":"28","author":"Zhang","year":"2015","journal-title":"Proc (Bayl Univ Med Cent)"},{"key":"2026033110351421000_13.1.e004098.4","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1093\/eurheartj\/ehac618","article-title":"Survival of patients with congenital ventricular septal defect","volume":"44","author":"Eckerstr\u00f6m","year":"2023","journal-title":"Eur Heart J"},{"key":"2026033110351421000_13.1.e004098.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.017226"},{"key":"2026033110351421000_13.1.e004098.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1990.tb00237.x"},{"key":"2026033110351421000_13.1.e004098.7","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1159\/000448513","article-title":"Long-Term Outcome of Patients with Perimembranous Ventricular Septal Defect: Results from the Belgian Registry on Adult Congenital Heart Disease","volume":"136","author":"Gabriels","year":"2017","journal-title":"Cardiology"},{"key":"2026033110351421000_13.1.e004098.8","unstructured":"Socialstyrelsen . National patient register. 2019. Available: https:\/\/www.socialstyrelsen.se\/en\/statistics-and-data\/registers\/national-patient-register"},{"key":"2026033110351421000_13.1.e004098.9","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-11-450","article-title":"External review and validation of the Swedish national inpatient register","volume":"11","author":"Ludvigsson","year":"2011","journal-title":"BMC Public Health"},{"key":"2026033110351421000_13.1.e004098.10","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-016-0117-y"},{"key":"2026033110351421000_13.1.e004098.11","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-017-0316-1"},{"key":"2026033110351421000_13.1.e004098.12","unstructured":"Classification of operations, Swedish version, 6th edition. 1993. Available: https:\/\/www.socialstyrelsen.se\/globalassets\/sharepoint-dokument\/dokument-webb\/klassifikationer-och-koder\/klassifikation-av-operationer-sjatte-upplagan.pdf"},{"key":"2026033110351421000_13.1.e004098.13","unstructured":"Classification of surgical procedures, Swedish version. 2004."},{"key":"2026033110351421000_13.1.e004098.14","unstructured":"R Core Team . R: a language and environment for statistical computing. 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