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Published in: Pediatric Cardiology 2/2017

Open Access 01-02-2017 | Original Article

Surgical Repair of Ventricular Septal Defect; Contemporary Results and Risk Factors for a Complicated Course

Authors: Maartje Schipper, Martijn G. Slieker, Paul H. Schoof, Johannes M. P. J. Breur

Published in: Pediatric Cardiology | Issue 2/2017

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Abstract

Surgical closure of the ventricular septal defect is the most commonly performed procedure in pediatric cardiac surgery. There are conflicting data on weight at operation as risk factor for a complicated course. We performed a retrospective evaluation of mortality and morbidity in all patients undergoing surgical ventricular septal defect closure at our institution between 2004 and 2012 to identify risk factor for a complicated course. Multivariate logistic regression modeling was performed to identify risk factors for a complicated course. 243 patients who underwent surgical ventricular septal defect closure were included. Median age at operation was 168.0 days (range 17–6898), the median weight 6.0 kg (range 2.1–102.0). No deaths occurred. Two patients (0.8%) required a pacemaker for permanent heart block. Five patients (2.1%) underwent reoperation for a hemodynamically important residual ventricular septal defect. No other major adverse events occurred. No risk factors for major adverse events could be established. Multivariate analysis identified a genetic syndrome, long bypass time and low weight at operation as independent risk factors for a prolonged intensive care stay (>1 day) and prolonged ventilation time (>6 h). Contemporary results of surgical VSD closure are excellent with no mortality and low morbidity in this series. Although it is associated with increased ventilation time and a longer hospital stay, low bodyweight at operation is not associated with an increased risk of complications or major adverse events in our series.
Literature
1.
go back to reference Roguin N, Du ZD, Barak M, Nasser N, Hershkowitz S, Milgram E (1995) High prevalence of muscular ventricular septal defect in neonates. J Am Coll Cardiol 26(6):1545–1548CrossRefPubMed Roguin N, Du ZD, Barak M, Nasser N, Hershkowitz S, Milgram E (1995) High prevalence of muscular ventricular septal defect in neonates. J Am Coll Cardiol 26(6):1545–1548CrossRefPubMed
2.
go back to reference Sands AJ, Casey FA, Craig BG, Dornan JC, Rogers J, Mulholland HC (1999) Incidence and risk factors for ventricular septal defect in “low risk” neonates. Arch Dis Child Fetal Neonatal Ed 81(1):F61–F63CrossRefPubMedPubMedCentral Sands AJ, Casey FA, Craig BG, Dornan JC, Rogers J, Mulholland HC (1999) Incidence and risk factors for ventricular septal defect in “low risk” neonates. Arch Dis Child Fetal Neonatal Ed 81(1):F61–F63CrossRefPubMedPubMedCentral
3.
go back to reference Scully BB, Morales DL, Zafar F, McKenzie ED, Fraser CD Jr, Heinle JS (2010) Current expectations for surgical repair of isolated ventricular septal defects. Ann Thorac Surg 89(2):544–549 (discussion 550–1) CrossRefPubMed Scully BB, Morales DL, Zafar F, McKenzie ED, Fraser CD Jr, Heinle JS (2010) Current expectations for surgical repair of isolated ventricular septal defects. Ann Thorac Surg 89(2):544–549 (discussion 550–1) CrossRefPubMed
4.
go back to reference Anderson BR, Stevens KN, Nicolson SC et al (2013) Contemporary outcomes of surgical ventricular septal defect closure. J Thorac Cardiovasc Surg 145(3):641–647CrossRefPubMed Anderson BR, Stevens KN, Nicolson SC et al (2013) Contemporary outcomes of surgical ventricular septal defect closure. J Thorac Cardiovasc Surg 145(3):641–647CrossRefPubMed
5.
go back to reference Kogon B, Butler H, Kirshbom P, Kanter K, McConnell M (2008) Closure of symptomatic ventricular septal defects: how early is too early? Pediatr Cardiol 29(1):36–39CrossRefPubMed Kogon B, Butler H, Kirshbom P, Kanter K, McConnell M (2008) Closure of symptomatic ventricular septal defects: how early is too early? Pediatr Cardiol 29(1):36–39CrossRefPubMed
6.
go back to reference Jacobs ML, O’Brien SM, Jacobs JP et al (2013) An empirically based tool for analyzing morbidity associated with operations for congenital heart disease. J Thorac Cardiovasc Surg 145(4):1046–1057CrossRefPubMed Jacobs ML, O’Brien SM, Jacobs JP et al (2013) An empirically based tool for analyzing morbidity associated with operations for congenital heart disease. J Thorac Cardiovasc Surg 145(4):1046–1057CrossRefPubMed
7.
go back to reference Aydemir NA, Harmandar B, Karaci AR et al (2013) Results for surgical closure of isolated ventricular septal defects in patients under one year of age. J Card Surg 28(2):174–179CrossRefPubMed Aydemir NA, Harmandar B, Karaci AR et al (2013) Results for surgical closure of isolated ventricular septal defects in patients under one year of age. J Card Surg 28(2):174–179CrossRefPubMed
9.
go back to reference Bol Raap G, Meijboom FJ, Kappetein AP, Galema TW, Yap SC, Bogers AJ (2007) Long-term follow-up and quality of life after closure of ventricular septal defect in adults. Eur J Cardiothorac Surg 32(2):215–219CrossRefPubMed Bol Raap G, Meijboom FJ, Kappetein AP, Galema TW, Yap SC, Bogers AJ (2007) Long-term follow-up and quality of life after closure of ventricular septal defect in adults. Eur J Cardiothorac Surg 32(2):215–219CrossRefPubMed
10.
go back to reference Roos-Hesselink JW, Meijboom FJ, Spitaels SE et al (2004) Outcome of patients after surgical closure of ventricular septal defect at young age: longitudinal follow-up of 22–34 years. Eur Heart J 25(12):1057–1062CrossRefPubMed Roos-Hesselink JW, Meijboom FJ, Spitaels SE et al (2004) Outcome of patients after surgical closure of ventricular septal defect at young age: longitudinal follow-up of 22–34 years. Eur Heart J 25(12):1057–1062CrossRefPubMed
11.
go back to reference Menting ME, Cuypers JAAE, Opić P et al (2015) The unnatural history of the ventricular septal defect. Outcome up to 40 years after surgical closure. JACC 65(18):1941–1951CrossRefPubMed Menting ME, Cuypers JAAE, Opić P et al (2015) The unnatural history of the ventricular septal defect. Outcome up to 40 years after surgical closure. JACC 65(18):1941–1951CrossRefPubMed
Metadata
Title
Surgical Repair of Ventricular Septal Defect; Contemporary Results and Risk Factors for a Complicated Course
Authors
Maartje Schipper
Martijn G. Slieker
Paul H. Schoof
Johannes M. P. J. Breur
Publication date
01-02-2017
Publisher
Springer US
Published in
Pediatric Cardiology / Issue 2/2017
Print ISSN: 0172-0643
Electronic ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-016-1508-2

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