Outcome of ventricular septal defect closure

To identify the factors affecting the outcome, measured in terms of morbidity and mortality, after primary ventricular septal defect (VSD) closure.

Descriptive study.

Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi, from January 2002 to October 2003.

Children upto the age of 5 years who had primary VSD closure were studied. Patients were divided into two groups. Group-I included survivors and group-II included non-survivors. There was no difference in the conduct of operation among the two groups.

A total of 53 patients were operated of whom 47 survived. Pulmonary hypertensive crisis (p < 0.001), pulmonary infections (p < 0.001) and pleural effusions (p < 0.003) were higher in non-survivor group. Patients in non survivor group were younger (0.75 + 0.34 years vs 2.24 + 1.16 years, p = 0.01) having less body weight (4.91 + 1.56 kg vs 7.94 + 3.35, p = 0.03) and high pulmonary artery to systemic pressure ratio at the time of coming off bypass (0.63 + 0.13 vs 0.43 + 0.09, p < 0.001). Non survivors had higher association (66.6 % vs 19.1%) of additional left to right shunts (p < 0.001).

Body weight less than 5 kg along with young age, high pulmonary artery to systemic pressure ratio at the time of coming off bypass and presence of additional left to right shunt are risk factors for adverse outcome.