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Ventricular septal defect with congenital mitral valve disease: long-term results of corrective surgery

Saket Agarwal1, Balram Airan, Ujjwal K Chowdhury

  • 1Department of Cardiothoracic Surgery, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi.

Indian Heart Journal
|May 10, 2002
PubMed

Insights

Surgical repair of ventricular septal defect (VSD) and congenital mitral valve disease is feasible. Careful long-term follow-up is crucial for managing potential mitral valve issues after VSD repair.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Congenital heart disease, including ventricular septal defect (VSD) and mitral valve anomalies, requires complex surgical intervention.
  • This study analyzes outcomes of combined VSD repair and mitral valve surgery.

Purpose of the Study:

  • To evaluate the mortality, morbidity, and long-term outcomes of patients undergoing corrective surgery for VSD with congenital mitral valve disease.
  • To assess the feasibility and effectiveness of mitral valve reconstruction in conjunction with VSD closure.

Main Methods:

  • Retrospective analysis of 69 patients (2 months to 45 years) undergoing VSD repair and mitral valve surgery between 1991 and 2000.
  • VSD repair performed via the right atrium; mitral valve reconstruction or replacement as indicated.
  • Detailed assessment of early and late mortality, morbidity, reoperation rates, and long-term survival.

Main Results:

  • 69 patients underwent combined VSD repair and mitral valve surgery, with 52 having perimembranous/subarterial VSDs.
  • Congenital mitral incompetence (46 patients) and stenosis (23 patients) were common. Mitral valve reconstruction was performed in 65 patients.
  • Early mortality was 8.6% (6 deaths); late mortality was 4 deaths. Actuarial survival at 10 years was 85.0% ± 5.0%, with freedom from reoperation at 45% ± 10.0%.

Conclusions:

  • Mitral valve reconstruction combined with VSD closure is achievable in the majority of cases.
  • Long-term surveillance is essential to monitor for evolving mitral valve dysfunction and other complications post-surgery.
Abstract

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