Ventricular septal defect (VSD) is a common congenital heart disease. However, consensus on the utility of echocardiography in predicting spontaneous closure (SC) of VSD remains lacking. This study aimed to identify and validate significant predictors of SC through a predictive scoring system. This retrospective study included medical records of 712 echocardiography instances performed on 304 patients diagnosed with VSD from 2016 to 2020 in their first year of life. A novel scoring system for predicting the SC of VSD was developed and validated using another dataset from different hospitals. Of the 304 patients, 215 (70.7%) had perimembranous (PM) VSDs and 89 had muscular (29.3%) VSDs. The median follow-up periods were 36.2 (interquartile range [IQR], 13–59) months and 13.7 9 (IQR, 5–37.4) days for PM and muscular VSDs, respectively. The overall SC rate during follow-up was 29.3%. Pulmonary hypertension (HTN), concomitant left ventricle (LV)–right atrium (RA) shunt, VSD size to aortic valve (AV) annulus size ratio, and left ventricular end-diastolic dimension (LVEDD) z-score were significant risk factors affecting SC of VSD. The “P-VSD” score, a new scoring system, demonstrated an area under the curve for predictability of 0.769. Pulmonary HTN, concomitant LV–RA shunt, LVEDD z-score, and VSD size-to-AV annulus size ratio at diagnosis were significantly associated with non-SC VSD after infancy. The P-VSD score can predict the SC of VSD in clinical settings and simplify the identification and appropriate management of high-risk patients.

室间隔缺损（VSD）是一种常见的先天性心脏病。然而，关于超声心动图在预测 VSD 自发闭合 (SC) 方面的应用仍缺乏共识。本研究旨在通过预测评分系统识别和验证 SC 的重要预测因素。这项回顾性研究包括 2016 年至 2020 年期间对 304 名被诊断患有 VSD 的患者进行的 712 例超声心动图检查。使用来自不同医院的另一个数据集开发并验证了一种用于预测 VSD SC 的新型评分系统。在 304 名患者中，215 名 (70.7%) 患有膜周 (PM) VSD，89 名患有肌肉 (29.3%) VSD。PM 和肌肉 VSD 的中位随访时间分别为 36.2（四分位距 [IQR]，13-59）个月和 13.7±9（IQR，5-37.4）天。随访期间总体 SC 率为 29.3%。肺动脉高压 (HTN)、伴随左心室 (LV)-右心房 (RA) 分流、VSD 大小与主动脉瓣 (AV) 瓣环大小之比以及左心室舒张末期 (LVEDD) z 评分是影响VSD 的 SC。新评分系统“P-VSD”评分显示可预测性曲线下面积为 0.769。诊断时的肺 HTN、伴随的 LV-RA 分流、LVEDD z评分以及 VSD 大小与 AV 环大小之比与婴儿期后的非 SC VSD 显着相关。P-VSD评分可以预测临床环境中VSD的SC，并简化高危患者的识别和适当管理。