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[Surgical treatment for ventricular septal defect in infants under 5 kg of body weight]
Zhuo Shi1, Qiang Shu, Ze-wei Zhang
1The Affiliated Childern's Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Insights
Surgical repair of ventricular septal defect (VSD) in infants under 5 kg yields satisfactory results when indications, timing, and perioperative management are optimized. This approach ensures good long-term development for most infants undergoing VSD surgery.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Defects
- Surgical Outcomes
Context:
- Infants weighing less than 5 kg with ventricular septal defects (VSD) present unique surgical challenges.
- Optimal timing and surgical techniques are crucial for successful VSD repair in this low-body-weight population.
Purpose:
- To review the indications, surgical timing, techniques, and perioperative management for ventricular septal defect (VSD) repair in infants under 5 kg.
- To evaluate the clinical outcomes and complications associated with VSD repair in this specific infant cohort.
Summary:
- A retrospective review of 134 infants under 5 kg with VSD and associated anomalies treated between 2000 and 2005.
- The study reports a low mortality rate (0.7%) and identifies common postoperative complications such as pneumonia and pulmonary hypertensive crisis.
- Long-term follow-up demonstrated satisfactory development in 133 surviving infants, with spontaneous closure of residual shunts in two cases.
Impact:
- Demonstrates the feasibility and satisfactory outcomes of VSD repair in low-body-weight infants when managed appropriately.
- Highlights the importance of careful patient selection, surgical technique, and perioperative care for improving results in pediatric VSD surgery.
- Provides valuable insights for optimizing the surgical management of congenital heart defects in the smallest and most vulnerable patient population.
Objective:
To review the indication and timing of surgery,surgical techniques and perioperative management of ventricular septal defect (VSD) repair on infants under 5 kg of body weight.
Methods:
From January, 2000 to December, 2005, 134 children patients with VSD and associated anomalies, who were under 5 kg of body weight and aged (3.9+/-1.9) months, were diagnosed and treated in our department.
Results:
One case died of arrhythmia and heart failure in the early stage of postoperation (mortality 0.7%). The most common postoperative complications were pneumonia (14), pulmonary hypertensive crisis (6), arrhythmia (4), low cardiac output (4), dropsy of thoracic cavity(1). Followed up for 6 m-6 y, the development of all 133 cases was well. Two children with residual shunt got a spontaneous closure confirmed by echocardiography one year postoperatively.
Conclusion:
The clinical results of operations on VSD infants with low body weight are satisfactory with attention to the indication and timing of surgery, proper CPB management, rational operations and perioperative management.
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