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Updated: Jul 20, 2026
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
[Differences in postoperative course by preoperative left ventricular volume after closure of ventricular septal
Takeshi Hiramatsu1, Y Harada, N Hibino
1Department of Cardiovascular Surgery, Nagano Children's Hospital, Nagano, Japan.
Insights
Infants with larger preoperative left ventricular volume (LVEDV > 250% N) and ventricular septal defect (VSD) face prolonged recovery and worse cardiac function. Careful postoperative management and surgical timing are crucial for these high-risk pediatric patients.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Cardiac Surgery
Context:
- Ventricular septal defect (VSD) is a common congenital heart anomaly.
- Preoperative left ventricular end-diastolic volume (LVEDV) is a potential indicator of surgical risk.
- Early infants present unique challenges in managing VSD.
Purpose:
- To investigate the impact of preoperative left ventricular end-diastolic volume (LVEDV) on the postoperative outcomes of infants with VSD.
- To identify high-risk patient groups requiring specialized perioperative care.
Summary:
- A study of 38 infants with VSD divided them into two groups based on LVEDV (>250% N vs. <250% N).
- Group A (LVEDV > 250% N) experienced significantly longer intubation, catecholamine support, and hospitalization.
- Postoperative, Group A showed impaired left ventricular fractional shortening (LVSF) compared to Group B, despite similar reductions in right ventricular pressure.
Impact:
- Preoperative larger LV volume in VSD infants identifies a high-risk group with potential cardiac and pulmonary complications.
- These high-risk patients exhibit prolonged postoperative courses and poorer recovery of left ventricular function.
- Mandatory special care in postoperative management and optimal timing of surgery are critical for improving outcomes in these infants.
Abstract:
A total of 38 early infants with ventricular septal defect (VSD) were divided into 2 groups by preoperative LVEDV. The group A (n=14, LVEDV>250% N) showed significantly longer period of intubation, cathecholamine drip, and hospitalization compared with the group B (n=28, LVEDV<250% N). At dischage, both groups showed significant lowered right ventricular (RV) pressure, but LVSF in the group A was significantly lower than that in the group B. The patients with larger left ventricular (LV) volume preoperatively were thought to be potential high-risk groups in cardiac and pulmonary function and their postoperative course was prolonged and recovery of LV function was worse. In such patients, special care is mandatory to do postoperative management and to decide timing of operation.
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