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Surgical management of multiple ventricular septal defects
The Journal of Thoracic and Cardiovascular Surgery
|October 1, 1980
Summary
Surgical closure of multiple ventricular septal defects (VSDs) in 29 patients showed a 14% mortality rate, influenced by defect complexity. Reoperation for overlooked muscular VSDs occurred in 28% of cases.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Multiple ventricular septal defects (VSDs) present complex surgical challenges.
- Accurate preoperative diagnosis and surgical technique are crucial for successful VSD closure.
Purpose of the Study:
- To evaluate the outcomes of surgical closure for multiple VSDs.
- To identify factors influencing mortality and reoperation rates.
- To assess the effectiveness of surgical VSD repair in achieving satisfactory hemodynamic results.
Main Methods:
- Retrospective review of 29 patients undergoing surgical closure of multiple VSDs between 1973 and 1979.
- Analysis of patient demographics, underlying cardiac malformations, surgical procedures, and outcomes.
- Statistical analysis to determine factors related to mortality and reoperation.
Main Results:
- Overall hospital mortality was 14% (4/29), significantly related to malformation complexity and associated cardiac lesions.
- Reoperation for overlooked VSDs was required in 28% (8/29) of cases, associated with muscular VSDs and preoperative underdiagnosis.
- Postoperative Qp/Qs ratios indicated satisfactory hemodynamic results in 85% (17/20) of patients with available data.
Conclusions:
- Surgical repair of multiple VSDs can yield satisfactory results.
- Early assessment for residual shunting and prompt reoperation when indicated are essential.
- Minimizing overlooked muscular VSDs through improved preoperative diagnosis is critical.