Related Experiment Video
Updated: Jul 13, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Repair of ventricular septal defect in the first year of life
Insights
Surgical repair of ventricular septal defect (VSD) in infants showed a low mortality rate. The right trans-atrial approach proved effective for VSD closure with minimal complications.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Surgery
Background:
- Ventricular septal defect (VSD) is a common congenital heart anomaly.
- Progressive left ventricular dysfunction, pulmonary hyperperfusion, and pulmonary hypertension necessitate surgical intervention.
Purpose of the Study:
- To evaluate the outcomes of surgical repair for ventricular septal defect (VSD) in infants.
- To assess the safety and efficacy of the right trans-atrial approach for VSD repair.
Main Methods:
- Retrospective analysis of 48 infants undergoing VSD repair between 1976 and 1982.
- Surgical repair utilized a right trans-atrial approach, with patch or tunnel techniques.
- Simultaneous closure of co-existing patent ductus arteriosus and atrial septal defects when present.
Main Results:
- Overall postoperative mortality was 6% (3 deaths).
- The right trans-atrial approach facilitated repair in 90% of cases.
- Specific complications included one case requiring re-repair and one permanent AV-block; mortality was 2% with this approach.
Conclusions:
- Surgical repair of VSD in infants can be performed with acceptable mortality and morbidity.
- The right trans-atrial exposure is an effective surgical strategy for VSD repair in this pediatric population.
- Early surgical intervention is crucial for managing VSD-related cardiac dysfunction.
Abstract:
In the 7-year period 1976 through 1982, 48 infants underwent repair of ventricular septal defect (VSD). Their mean age was 5.3 (range 1-11) months and mean body weight 5.4 (range 3.1-9.6) kg. "Uncomplicated" VSD, located in the membranous septum, was present in 33 cases. "Complicated" VSD in terms of muscular/multiple (n = 6), subaortic type of double-outlet right ventricle (n = 5), AV-canal type (n = 2) and straddling chordae (n = 2) was present in 15 cases. The indication of surgery was progressive left ventricular dysfunction due to pulmonary hyperperfusion and pulmonary hypertension. Right trans-atrial exposure permitted repair, patch or tunnel in 43 of the 48 infants (90%), although temporary detachment of the septal tricuspid leaflet was required on six occasions. Co-existing patent ductus arteriosus (n = 6) and atrial septal defect (n = 22) were simultaneously closed. There were three postoperative deaths (6%). One infant required a second-stage repair for incomplete VSD closure and one sustained a permanent AV-block II. Repair via right atrial exposure was associated with few complications and only one death (2%).
