Objectives: In a group of older adults, born with a ventricular septal defect, either surgically closed earlier in life or deemed insignificant and thus unrepaired, a number of abnormal findings were recently described. These included among others reduced heart rate variability, lower exercise capacity and disrupted biventricular contractility during physical activity. The quality of life, health behavior and self-rated physical and mental health have not previously been determined in older adults with a congenital VSD. Therefore, a comprehensive questionnaire was provided to a homogenous group of adults with a congenital VSD and matched with answers from a comparable sample of the background population.

Methods: A questionnaire was distributed to adults in their mid-50s with congenital VSDs, who were concurrently being included as part of another clinical research study. The questionnaire form from the Danish National Health Survey, containing a total of 52 questions, among others the SF-12 health-related quality of life and Perceived Stress Scale, was used to evaluate health behavior and quality of life. Data from completed questionnaire in the same time period distributed to the background population, matched on age and gender with the patients, were extracted from the database. A subgroup analysis was performed with patients being divided into two groups with either a surgically closed or an unrepaired VSD.

Results: A group of 60 adults with a surgically closed or unrepaired VSD (52.9±10) and 600 matched controls (52.5±10) completed the questionnaire. Sociodemographic data were comparable between patients and background population regarding employment status, social relations, cohabiting status, alcohol consumption and physical activity habits. More patients reported of migraine (40% vs. 27%, p=0.02) as well as currently being severely affected by depression or unhappiness (11.7% vs. 4.8%, p=0.03) as compared with the background population. Regarding self-rated physical status, patients reported of lower physical functioning (p<0.01), general health perception (p=0.02) and physical component score (p=0.04) as compared with the background population. Furthermore, 8.5% of patients reported of high levels of perceived stress compared with 2.2% of the background population, p=0.01. Subgroup analysis revealed lower self-reported physical functioning (p<0.01), role physical (p=0.01), general health perception (p=0.01) and physical component summary (p<0.01) in patients with surgically closed VSD compared with patients with unrepaired VSD. 

Conclusion: Older patients with a congenital VSD report of lower self-perceived physical functioning, a reduced general health perception as well as higher levels of stress as compared with the background population. These findings are all in line with previously demonstrated abnormal results such as lower functional capacity and exercise biventricular contractility, which may very likely be associated with the self-reported reduced physical health. The growing list of reduced quantitative clinical and subjective findings suggest that a VSD, whether repaired early or considered hemodynamically insignificant, is not a benign lesion and continuous follow-up of this aging patient group is warranted.