Surgical Repair of Ventricular Septal Defect; Contemporary Results and Risk Factors for a Complicated Course.
Surgical closure of the ventricular septal defect is the most commonly performed procedure in pediatric cardiac surgery. There are conflicting data on weight at operation as risk factor for a complicated course. We performed a retrospective evaluation of mortality and morbidity in all patients undergoing surgical ventricular septal defect closure at our institution between 2004 and 2012 to identify risk factor for a complicated course. Multivariate logistic regression modeling was performed to identify risk factors for a complicated course. 243 patients who underwent surgical ventricular septal defect closure were included. Median age at operation was 168.0 days (range 17-6898), the median weight 6.0 kg (range 2.1-102.0). No deaths occurred. Two patients (0.8%) required a pacemaker for permanent heart block. Five patients (2.1%) underwent reoperation for a hemodynamically important residual ventricular septal defect. No other major adverse events occurred. No risk factors for major adverse events could be established. Multivariate analysis identified a genetic syndrome, long bypass time and low weight at operation as independent risk factors for a prolonged intensive care stay (>1 day) and prolonged ventilation time (>6 h). Contemporary results of surgical VSD closure are excellent with no mortality and low morbidity in this series. Although it is associated with increased ventilation time and a longer hospital stay, low bodyweight at operation is not associated with an increased risk of complications or major adverse events in our series.
['Schipper|Maartje|M|', 'Slieker|Martijn G|MG|', 'Schoof|Paul H|PH|', 'Breur|Johannes M P J|JM|']
D000293:Adolescent D006348:Cardiac Surgical Procedures D002648:Child D002675:Child, Preschool D005260:Female D006327:Heart Block D006345:Heart Septal Defects, Ventricular D006801:Humans D007223:Infant D007231:Infant, Newborn D016015:Logistic Models D008297:Male D015999:Multivariate Analysis D009426:Netherlands D010372:Pediatrics D011183:Postoperative Complications D012086:Reoperation D012189:Retrospective Studies D012307:Risk Factors D013997:Time Factors D016896:Treatment Outcome
Ventricular septal defect Risk factors Pediatric cardiac surgery Cardiac surgery Congenital heart disease Pediatric cardiology