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Surgery for doubly committed ventricular septal defects.

Ahmad Mahir Shamsuddin1, Yen Chuan Chen2, Abdul Rahim Wong3

  • 1Pediatric and Congenital Cardiac Surgery Unit, Department of Surgery, School of Medical Sciences, Health Campus, University of Sains Malaysia, Kubang Kerian, Kelantan, Malaysia amahir@gmail.com.

Interactive Cardiovascular and Thoracic Surgery
|May 13, 2016
PubMed
Summary
This summary is machine-generated.

Doubly committed ventricular septal defects (VSDs) are common in Asian populations and often require surgical repair. Patch closure is effective for VSDs, even with associated conditions like aortic valvular regurgitation.

Keywords:
Aortic valvular regurgitationDevice closureDoubly committed and juxta-arterial ventricular septal defectSurgeryVentricular septal defect

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Area of Science:

  • Cardiology
  • Pediatric Cardiac Surgery
  • Congenital Heart Defects

Background:

  • Doubly committed ventricular septal defects (VSDs) represent a significant portion of isolated VSDs in Asian populations, contrasting with Western demographics.
  • These defects are frequently associated with aortic valvular regurgitation (AoVR) and other cardiac malformations, necessitating specialized surgical approaches.
  • Patch closure has historically been the preferred surgical method for doubly committed VSDs.

Purpose of the Study:

  • To evaluate the surgical indications for doubly committed VSDs.
  • To examine the outcomes of surgical repair for doubly committed VSDs, including associated complications and long-term results.

Main Methods:

  • A retrospective review of 17 pediatric patients who underwent surgical closure of doubly committed VSDs between October 2013 and December 2014.
  • Patient data included age, weight, defect size, preoperative AoVR, and associated malformations.
  • Surgical outcomes assessed included residual shunting, persistent AoVR, intensive care unit and hospital stay, and follow-up duration.

Main Results:

  • Seventy-one percent of referred VSD cases were doubly committed defects, with a median age of 6 years.
  • Preoperative AoVR was present in 65% of patients, and 82% had associated malformations.
  • Postoperative outcomes showed minimal residual shunting in 12% and persistent AoVR in 35%, with no mortality and good clinical status at follow-up.

Conclusions:

  • Doubly committed VSDs are prevalent in this cohort and often present with AoVR and complex malformations.
  • Early detection and surgical intervention are vital for managing these complex defects.
  • Patch closure remains the gold standard, facilitating simultaneous repair of doubly committed VSDs and associated intracardiac anomalies.