SURGICAL CLOSURE OF VENTRICULAR SEPTAL DEFECT – EXPERIENCE AT ARMED FORCES INSTITUTE OF CARDIOLOGY

Abstract

Objective: To evaluate the results of surgical closure of ventricular septal defect (VSD) with special focus on
immediate complications and mortality.
Study Design: Quasi experimental study.
Place and Duration of Study: Pediatric cardiac surgical department of Armed Forces Institute of Cardiology /
National Institute of Heart Diseases (AFIC/NIHD) from 1stJanuary 2011 to 31st Dec 2012.
Patients and Methods: All patients undergoing surgical closure of VSD were included in the study. All patients
underwent detailed pre-operative assessment including detailed examination, blood tests, chest x-ray,
echocardiography and doppler. The surgery was performed under general anesthesia. VSD was closed using
polytetrafluoroethylene (PTFE) patch with prolene interrupted sutures. Good post operative care was ensured.
The patients were discharged on 7th post-operative day and advised follow up after one week.
Results:A total of 230 consecutive patients underwent VSD closure with male to female ratio of 2.2:1and mean
age was 5.7±6.5 years. Mean height was 94.8 ± 31.4 cms and mean weight was 15.3 ± 12.6 kgs. Per membranous
VSDs were most common accounting for 67.4% of cases. Indications for surgery were moderate to large VSDs
(77.8%), associated with other congenital heart diseases (CHDs) (8.3%), coronary cusp prolapse with or without
aortic regurgitation (13.5%) and infective endocarditis (0.4%). In one case aortic valve replacement was also done
for severe aortic regurgitation due to gross right coronary cusp prolapse. There were 10 (4.3%) deaths in study
....
Conclusion: Open heart surgery for VSD is safe with low mortality in experienced hands.