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Updated: Oct 17, 2026
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
[Surgical correction of symptomatic ventricular septal defects in patients less than 6 months of age]
A Cabrera Duro1, P Martínez Corrales, A Llorente Urcullo
1Hospital Infantil de Cruces, Vizcaya.
Insights
Single surgery effectively corrects symptomatic ventricular septal defects in infants. This approach offers a safe and adequate solution for young children requiring intervention for VSDs.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Defects
Context:
- Infants with symptomatic ventricular septal defects (VSDs) often require surgical intervention.
- Early surgical management is crucial for improving outcomes in congenital heart disease.
- Evaluating the efficacy of single-stage surgical repair is important for clinical practice.
Purpose:
- To assess the effectiveness of a single surgical procedure for treating symptomatic interventricular septal defects in infants under six months old.
- To determine the safety and feasibility of early surgical correction for VSDs.
- To analyze the short-term outcomes and complications associated with VSD repair.
Summary:
- Forty-two infants with symptomatic VSDs underwent surgical repair using deep hypothermia.
- No perioperative mortality was observed, with short intensive care unit and hospitalization stays.
- While some immediate complications occurred, only two patients required reintervention during follow-up.
Impact:
- One-time surgery appears to be an adequate and safe method for correcting symptomatic VSDs in this age group.
- The findings support the use of early, single-stage surgical intervention for VSDs.
- This study contributes to the understanding of surgical outcomes for congenital heart defects in neonates and infants.
Objective:
Our objective was to evaluate the efficiency of a single surgical intervention in patients with symptomatic interventricular septal defects during the first six months of life.
Patients And Methods:
Between 1989 and 1997, 42 patients, 20 males and 22 females with an average age of 3.9 +/- 0.3 months and an average weight of 4 +/- 0.4 kg, were operated. Seven suffered from Down's syndrome. All of the patients became symptomatic during the first two months of life. The defect was localized by using Echo-Doppler in all of the cases. Thirty-six had perimembranous ventricular septal defects, 2 were muscular, 3 multiple and 1 was infundibular. The average defect size was 8 +/- 1.2 mm. A catheter was placed in 34 patient with the following results: Left to right shunt with 2.2 +/- 1.2, right ventricle systolic pressure of 57 +/- 20 mmHg (16 with systemic pulmonary pressure) and an average pulmonary pressure of 38 +/- 1.8 mmHg. The average pulmonary vascular resistance was 28 +/- 1.8 U/m2. Deep hypothermia (18 degrees C was applied during the surgery and the average cardiac arrest time was 31 +/- 4 minutes.
Results:
None of the patients died during or after the surgical procedure. Patients required minimum ionotropic support during the first hours. The average time in the intensive care unit was 3.5 +/- 0.6 days, with an average hospitalization time of 11.2 +/- 2.1 days. Immediate complications included one hypertensive crisis, four junctional ectopic tachycardias, two atrio-ventricular blocks, 1 transient arrhythmia, two atelectasia-pneumonias, two patients with stridor and two sternal infections. During the follow-up period, two patients required a second intervention to repair the patch.
Conclusions:
We believe that one-time surgery is adequate to correct symptomatic ventricular septal defects.
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