Abstract
BackgroundSurgical closure of multiple ventricular septal defects (VSDs) is challenging and associated with a high complication rate. Several factors may affect the outcomes after surgical repair of multiple VSDs. We aimed to report the outcomes after surgical repair of multiple VSDs before and after 1 year and identify the factors affecting the outcomes. We have studied forty-eight patients between 2016 and 2017 who had surgical repair of multiple VSDs. We grouped them according to the age at the time of repair. Study outcomes were hospital complications, prolonged hospital stay, and reoperation.ResultsThere were 18 females (60%) in group 1 and 13 (72.22%) in group 2 (P = 0.39). There were no differences in the operative outcomes between the groups. Prolonged postoperative stay was associated with group 1 (OR 0.23 (0.055–0.96); P = 0.04) and lower body weight (OR 0.76 (0.59–0.97); P = 0.03). Hospital mortality occurred in 2 patients (6.67%) in group 1 and 1 patient (5.56%) in group 2 (P > 0.99). Five patients had reoperations: two for residual VSDs, two for subaortic membrane resection, and one for epicardial pacemaker implantation. All reoperations occurred in group 1 (log-rank P = 0.08). Two patients had transcatheter closure of the residual muscular VSDs; both were in group 2.ConclusionsSurgical repair of multiple VSDs was associated with good hospital outcomes. The outcomes were comparable in patients younger or older than 1 year of age. Young age at repair could lead to prolonged postoperative stay and a higher reoperation rate.
Highlights
Surgical closure of multiple ventricular septal defects (VSDs) is challenging and associated with a high complication rate
There were no differences in cardiopulmonary bypass (CPB) and aortic cross-clamp times and the number of VSDs closed between the groups
We presented continuous data as median (Q1–Q3) and binary or ordinal data as frequency and percentage occurred in patients who had associated transposition of great arteries (TGA), hypoplastic right ventricle (RV), and pulmonary valve and right infundibular stenosis
Summary
Surgical closure of multiple ventricular septal defects (VSDs) is challenging and associated with a high complication rate. We have studied forty-eight patients between 2016 and 2017 who had surgical repair of multiple VSDs. We grouped them according to the age at the time of repair. Surgical repair of multiple VSDs is challenging and associated with residual defects, heart block, and mortality [3, 4]. Despite the advancement of surgical techniques for managing multiple VSDs [3, 6], the complications and mortality rates remain high. Reports advocated the staged repair of multiple VSDs by performing pulmonary artery banding; this approach was associated with high mortality and septal hypertrophy; several authors recommended. Our objective was to report the outcomes after repairing multiple VSDs before and after 1 year of age and assess the factors that influenced the results
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