Social function of adults with isolated ventricular septal defects. Possible negative effects of surgical repair?

Possible long-term deterioration of social function has been studied in adults over 30 years of age with congenital, isolated ventricular septal defects (VSD). This deterioration may possibly have been caused by brain damage connected with open heart surgery performed after age 10 years. Thirty-five patients with a mean age of 39 (range 31-61) years have been followed up for an average of 15 (3-21) years when restudied after surgical repair of VSD performed at a mean age of 23 (10-51) years (Group 1). Their social status was compared with 61 non-operated subjects with basically smaller defects, mean age 43 (31-73) years, who had been followed up for an average of 14 (3-21) years. Group 1 had a higher educational level, were less stressed at work, had a higher gross income (NS) and were less physically disabled (p less than 0.01). Both groups had a higher educational level than normal 40-year-old Norwegians. The percentages receiving disablement pension were 12% in group 1 and 13% in group 2. Despite a higher abortion rate (33% vs. 18%), group 1 females had a higher number of liveborn babies than those in group 2 (NS). Regular medical check-ups were attended by 45% and 60% in groups 1 and 2 respectively, and about half took antibiotics prophylactically. Unlike when initially investigated, group 1 had a better cardiac condition than group 2. Compared with the non-operated group, the operated patients had suffered no detrimental effects on their social function. We therefore advocate a liberal policy for surgical repair of VSD after age 10 years.