Surgical closure of ventricular septal defect - experience at Armed Forces Institute of Cardiology

ABSTRACT

To evaluate the results of surgical closure of ventricular septal defect [VSD] with special focus on immediate complications and mortality. Quasi experimental 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. 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 7[th] post-operative day and advised follow up after one week. A total of 230 consecutive patients underwent VSD closure with male to female ratio of 2.21and 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 population and their mean age was 3.5 +/- 5.5 years. In 02[0.9%] patients, permanent pacemaker was also implanted. Open heart surgery for VSD is safe with low mortality in experienced hands