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[Surgical closure of interventricular communications before 2 years of age. Long-term clinical and
Insights
Long-term follow-up of surgically closed ventricular septal defects (VSD) in infants shows excellent clinical tolerance. Conduction disorders remained stable or improved, with no sudden deaths or secondary heart blocks observed.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Congenital Heart Defects
Context:
- Surgical closure of ventricular septal defects (VSD) in young children.
- Focus on long-term outcomes and conduction disorders.
- Study cohort from 1972-1976 at Centre Chirurgical Marie-Lannelongue.
Purpose:
- To assess the long-term clinical follow-up of pediatric VSD surgical closure.
- To investigate the incidence and evolution of conduction disorders post-VSD repair.
- To evaluate the safety and efficacy of early VSD surgical intervention.
Summary:
- Follow-up of 100 children under 2 years with VSD undergoing surgical closure.
- Excellent clinical tolerance noted; one case of Eisenmenger's syndrome and three secondary aortic regurgitations.
- Conduction disorders showed no deterioration, with no sudden deaths or secondary atrioventricular blocks.
Impact:
- Demonstrates the favorable long-term safety of early VSD surgical closure in children.
- Highlights the stability or improvement of conduction status post-intervention.
- Provides evidence supporting surgical VSD repair for preventing severe cardiac complications.
Abstract:
The long-term follow-up of the first 100 children under 2 years of age, presenting with ventricular septal defect (VSD) who underwent surgical closure between 1972 and 1976 at the Centre Chirurgical Marie-Lannelongue, was studied. Only cases with isolated VSD were taken into account except for 18 cases with ductus arteriosus related to operation and 41 cases with atrial septal defect (ASD) or persistent foramen ovale. This study included clinical and electrocardiographic investigations focused on the long-term follow-up of conduction disorders. Clinical tolerance was excellent with only one Eisenmenger's syndrome induced by a residual VSD. Three secondary cases of aortic regurgitation without present functional repercussions were observed. Conduction disorders were considered as unchanged or even improved. There were no sudden death, no secondary atrioventricular block (AVB), no trifascicular block even after one case with transitory immediate postoperative AVB.