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Therapeutic strategy for multiple VSD combined with MVSD in infants and young children
1Department of Cardiothoracic Surgery, Fangzi District People's Hospital, Weifang Heart Disease Hospital, Weifang, Shandong Province, P.R. China. guangyiliu4@hotmail.com.
Insights
This study explored surgical strategies for multiple ventricular septal defects (VSD) in infants. Appropriate approaches led to satisfactory clinical outcomes for muscular VSD (MVSD) treatment.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease Surgery
Background:
- Multiple Ventricular Septal Defects (VSD) present complex therapeutic challenges in infants and young children.
- Muscular Ventricular Septal Defects (MVSD) require specific surgical considerations within the context of multiple VSDs.
Purpose of the Study:
- To investigate and define effective therapeutic strategies for multiple VSDs, particularly those combined with MVSD in pediatric patients.
- To evaluate the clinical outcomes of different surgical interventions for these complex cardiac conditions.
Main Methods:
- Analysis of clinical data from 63 pediatric patients treated for multiple VSD between January 2009 and April 2013.
- Surgical interventions included primary repair with suture, hybrid repair under direct vision, and hybrid repair via the right ventricle.
- Postoperative follow-up involved chest X-ray, EEG, and color Doppler echocardiography to assess MVSD closure and residual shunts.
Main Results:
- All 63 patients survived the perioperative period without mortality.
- Follow-up of 55 patients revealed residual shunts in 28, mostly less than 4 mm, requiring further observation.
- Delayed sternal closure was needed in three patients, and one experienced postoperative cardiac dysfunction.
Conclusions:
- Tailored surgical strategies based on specific intraoperative conditions are crucial for treating MVSD in infants with multiple VSDs.
- These individualized approaches can achieve satisfactory clinical outcomes and effective management of complex congenital heart defects.
Objective:
To investigate the therapeutic strategy for the multiple ventricular septal defects (VSD) combined with a muscular ventricular septal defect (MVSD) in the infants and young children.
Patients And Methods:
We analyzed clinical data of 63 child patients with multiple VSD who received the treatment between January 2009 and April 2013 in our hospital. There were 33 males and 30 females, the patients aged from 6 to 28 (10 ± 6) months and weighed between 5.5 and 18.0 (7.1 ± 2.9) kg. Primary repair was performed for all of the patients; the MVSD in 7 patients was not detected during the surgery and no extra treatment was taken. The surgical suture was performed for 36 patients, hybrid repair under the direct vision for 8 patients, and hybrid repair via the right ventricle for 7 patients. After surgery, we followed up the patients regularly to reexamine the X-ray image of the chest, EEG, and color Doppler echocardiography to observe the closure of MVSD and the presence of a residual shunt.
Results:
All of the 63 enrolled patients with multiple VSD survived without perioperative death. Three patients who were undergoing hybrid repair under direct vision received delayed sternal closure. One patient who was undergoing hybrid repair under direct vision had a postoperative cardiac dysfunction. 55 patients were followed up for 1 to 24 months. 28 patients had residual shunt of varying degrees during the follow-up, and most of the MVSD of patients with residual shunt was less than 4 mm, who were receiving further follow-up and observation.
Conclusions:
Appropriate surgical strategies can be applied according to the specific surgical condition for the treatment of MVSD in infants with multiple VSD, and the satisfactory clinical outcome can be achieved.
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