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[Residual postoperative murmurs in children with congenital heart defects]
1Medicinskom centru Nasice, Klinika za djecje bolesti, KBC Rebro, Zabreb.
Insights
Postoperative innocent murmurs are common in children after heart defect surgery, particularly ventricular septal defect (VSD) repair. Further investigation is needed for VSD murmurs, as some may not be functional.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Clinical Auscultation
Context:
- Study conducted at University Hospital Rebro from June 1989 to February 1991.
- Involved 54 children post-surgical correction for VSD, ASD II, and PDA.
- Focused on early postoperative period findings.
Purpose:
- To analyze the incidence and characteristics of heart murmurs in children following surgical correction of VSD, ASD II, and PDA.
- To differentiate between innocent/functional murmurs and potentially pathological ones.
Summary:
- 57% of children exhibited innocent or functional murmurs post-surgery.
- Murmurs were more frequent in Ventricular Septal Defect (VSD) patients compared to Atrial Septal Defect (ASD II) and Patent Ductus Arteriosus (PDA) groups.
- Anemia did not significantly influence murmur presence, though it was noted in some ASD II and PDA cases.
Impact:
- Suggests a higher likelihood of non-innocent murmurs in VSD patients, warranting further investigation.
- Findings contribute to understanding postoperative auscultatory findings in pediatric cardiac surgery.
- Highlights the need for careful auscultation and differential diagnosis in pediatric cardiac patients.
Abstract:
Fifty-four children without postoperative complications were admitted to the Department of Pediatrics, University Hospital Rebro, following a complete surgical correction of ventricular septal defect (VSD), atrial septal defect - secundum type (ASD II) and patent ductus arteriosus (PDA) in the period from June, 1989, to February, 1991. Twenty-two patients were treated surgically for VSD, 17 for ASD II and 15 for PDA. There were 23 male and 31 female children. In the early postoperative period, 57% of all the examinees had a murmur with the innocent or functional characteristics. The murmur was significantly more frequent among children with VSD than among children of other groups (ASD II, PDA). Sex, age and hematocrit did not influence this difference. There were 8 anemic children (3 with operated VSD, 4 with ASD II, and 1 with PDA). From this, it may be concluded that anemia also did not cause this difference. However, anemic children represented 50% of the examinees with a murmur among the operated for ASD II and 33% among those treated surgically for PDA. When these anemic children were eliminated, the others operated on for ASD II and PDA probably had the innocent murmurs, since the proportion of examinees with a murmur fits into the incidence of innocent murmurs in the population. The children operated for VSD have had a greater proportion of examinees with a murmur, and most likely, some of these murmurs do not belong to a group of innocent or functional murmurs. Their cause is unknown, as yet (probably, small organic lesion).(ABSTRACT TRUNCATED AT 250 WORDS)