Early postoperative mortality and morbidity after surgical repair of isolated congenital ventricular septal defect

ABSTRACT

During a 3-year period at the Riyadh Armed Forces Hospital, 128 patients under 12 years of age had elective surgical repair as the treatment of choice of isolated congenital ventricular septal defect [VSD]. The early postoperative mortality and morbidity during the period of stay in the intensive care unit [ICU] is reviewed retrospectively. Morbidity was assessed by the incidence of renal failure, pulmonary complications and recorded infection. The overall mean [ +/- SD] length of ICU stay was 4.7 +/- 7.8 days. Forty-nine patients [38%] had one or more pulmonary complications; infection was recorded in eight patients [6%]. There were no patients who developed renal failure and no deaths. Patients aged surgery had a significantly longer mean length of stay, with higher rates of pulmonary complications and recorded infection than those aged >12 months, despite a lower mean pulmonary vascular resistance. Fifty [39%] patients [Group A] who had VSD repair after deep hypothermia by surface cooling and circulatory arrest were significantly younger, had a significantly higher rate of pulmonary complications, with more recorded infection and a longer mean length of stay than the 78 patients [61%] who did not have surface cooling and circulatory arrest [Group B]. Subdivision of Groups A and B into age subgroups 12 months at surgery confirmed that patient age was an important prognosticator of early postoperative morbidity, whether deep hypothermia by surface cooling and circulatory arrest was used or not