Detection of Cardiac Remolding After Surgical Closure of Ventricular Septal Defect in Children Less Than One Year

Abstract

Background: Cardiac remodeling is an important issue after surgical closure of ventricular septal defect (VSD). Objective: The purpose of the present study was to evaluate cardiac remodeling by echocardiography by measuring the ejection fraction, fractional shortening, left ventricular internal diameter in diastole (LVIDd) and left ventricular internal diameter in systole (LVIDs) after surgical closure of VSD defect in patients less than 1 year. Methodology: This study was conducted in the department of pediatric cardiology, Maternity and Children Hospital (MCH), El Madina El Menwara, Saudi Arebia. Patients were divided into 3 groups according to the age. All patients presented with isolated perimembreanous VSD (PM-VSD) who were surgically treated at the age less than1 year. This study population was divided into 3 groups as group A from (0- 3) months, group B from (3- 6) months and group C from 6 months to 1 year. Echocardiographic variables such as ejection fraction, fractional shortening, LVIDd and LVIDs were taken pre operative and one month post operative in all groups. The echocardiography was repeated three months post operative in group B and group C. Result: A total number of 100 patients were recruited for this study. All the above parameters were normal 1 month after VSD closure in group group A. However, in both group B and group C the follow up echocardiography was indicated. In both groups the time was needed to reach the normal vlues. Conclusion: Cardiac remodeling is an important indicator of the ability of the cardiomyocyte to be changed to the normal shape and dimension. There are many factors that affect the cardiac cell. The presence of preload or afterload causes can result in delay of remodeling. As long as the patient start to take medication for anti failure cause, the suspicion of remodeling will be delayed