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[One stage repair of VSD in infants (author's transl)]
Insights
This study analyzed 27 deaths in infants undergoing surgery for large ventricular septal defects (VSD). No significant weight-based difference in mortality was observed between infants under and over 6 Kg.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Defects
- Surgical Outcomes
Context:
- Experience from February 1973 to May 1979 involving 258 infants (<12 Kg) with large Ventricular Septal Defects (VSD).
- Analysis focused on 27 mortality cases within the study cohort.
- Surgical techniques included hypothermia and circulatory arrest for infants <5 Kg, and moderate hypothermia with cardioplegic protection for others.
Purpose:
- To evaluate mortality rates and causes in infants undergoing surgical repair of large VSD.
- To determine if patient weight (<6 Kg vs. >6 Kg) significantly impacts outcomes.
- To identify factors contributing to mortality, including post-operative complications and pre-operative diagnostic errors.
Summary:
- No statistical difference in mortality was found between infants weighing less than 6 Kg (15 deaths/128 cases) and those weighing more than 6 Kg (11 deaths/130 cases).
- Causes of death were attributed to post-operative complications (bleeding, catheter issues, mediastinitis) or pre-operative errors (complex VSD types like Swiss cheese VSD, single ventricle).
- Pulmonary artery banding remains indicated for multiple VSDs and VSDs with other visceral malformations.
Impact:
- Provides insights into the surgical risks associated with large VSD repair in infants.
- Highlights the importance of accurate pre-operative diagnosis to mitigate mortality.
- Informs surgical decision-making and patient selection for VSD repair and pulmonary artery banding.
Abstract:
Concerning their experience between February 1973 and May 1979 about 258 infants less than 12 Kg operated up for large VSD, the authors studies the 27 deaths. Their is not statistical difference between patients under 6 Kg of weight (128 cases, 15 deaths) and patients over 6 Kg of weight (130 cases, 11 deaths). The procedure is performed under hypothermia and circulatory arrest under 5 Kg and moderate hypothermia with cardioplegic myocardial protection in other cases. The causes of deaths have been: --either post-op. complications (post-operative bleeding, catheter complication, mediastinitis), --or pre-operative error (Swiss cheese VSD, single ventricle). The indications for pulmonary artery banding remain multiples VSD, and VSD associated with other visceral malformations.