Spontaneous closure of a traumatic ventricular septal defect following a penetrating injury.

A ventricular septal defect acquired from a penetrating injury to the membranous septum closed spontaneously, as documented by repeat cardiac catheterization. The patient was asymptomatic from the time the lesion was discovered until the present. We advise observation of these lesions for a period of time, provided that no evidence of cardiac decompensation or pulmonary hypertension is noted as determined by hemodynamic studies and clinical observation. Cardiac catheterization is mandatory to confirm the diagnosis, measure the magnitude of the shunt, and rule out associated intracardiac injuries. We believe the lesion should be closed on an elective basis, regardless of the absence of symptoms, if after a reasonable time there is no evidence that the ventricular septal defect is closing and a significant shunt is demonstrated.