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Multiple ventricular septal defects: a new strategy

Antonio F Corno1, Pramod R Kandakure2, Ramana Rao V Dhannapuneni2

  • 1King Fahad Medical City Riyadh, Saudi Arabia.

Frontiers in Pediatrics
|January 9, 2014
PubMed

Insights

This study introduces a new strategy using an adjustable Pulmonary Artery Banding (PAB) device for infants with multiple Ventricular Septal Defects (VSDs). The approach resulted in 0% mortality and facilitated spontaneous closure of VSDs, simplifying management.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease Surgery

Background:

  • Multiple Ventricular Septal Defects (VSDs) present complex management challenges in infants.
  • A novel strategy involving adjustable Pulmonary Artery Banding (PAB) was evaluated.

Purpose of the Study:

  • To assess the efficacy and safety of a new strategy for managing multiple VSDs in infants.
  • To evaluate the use of an adjustable device for Pulmonary Artery Banding (PAB).

Main Methods:

  • A prospective, multicenter study included 17 infants with multiple VSDs undergoing PAB with an adjustable FloWatch-PAB device.
  • Patients had various associated cardiac anomalies and some required mechanical ventilation.
  • Follow-up averaged 48 months, with adjustments to the PAB device as needed.

Main Results:

  • No early or late deaths were observed.
  • All patients required FloWatch-PAB adjustments to manage pulmonary artery pressure.
  • 59% of patients underwent re-operation for PAB removal and VSD closure; 88% showed spontaneous closure of muscular VSDs.

Conclusions:

  • The adjustable PAB strategy simplifies management of multiple VSDs in infants, achieving 0% mortality.
  • This approach facilitates delayed surgical closure of residual VSDs at a higher body weight.
  • The strategy may be sufficient as the sole intervention for certain types of multiple VSDs.
Abstract

Keywords:
congenital heart defectsmultiple ventricular septal defectspalliationpulmonary artery bandingsurgical repair

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