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Long-term follow-up after surgical closure of ventricular septal defect in infancy and childhood
F Meijboom1, A Szatmari, E Utens
1Department of Pediatrics, Sophia Children's Hospital, Rotterdam, The Netherlands.
Insights
Surgical closure of ventricular septal defects in children yields good long-term health-related quality of life. Most patients report excellent health and normal exercise capacity years after the procedure.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease Surgery
- Quality of Life Research
Background:
- Surgical techniques for congenital cardiac malformations have advanced, enabling repair even in infants.
- Long-term quality of life data after early surgical repair of ventricular septal defects are limited.
- This study investigated long-term outcomes in patients operated on between 1968 and 1980.
Purpose of the Study:
- To assess the health-related quality of life in patients who underwent surgical closure of a ventricular septal defect at a young age.
- To evaluate long-term functional status and health outcomes post-pediatric VSD repair.
Main Methods:
- A follow-up study involving 176 infants and children operated on between 1968 and 1980.
- Participants underwent interviews, physical examinations, echocardiography, and exercise testing.
- Electrocardiography (12-lead and 24-h) was also performed to assess cardiac function.
Main Results:
- 109 patients (78% eligibility) participated, with a mean follow-up of 14.5 years.
- 84% rated their health as good/very good; 89% had no further medical/surgical interventions.
- Mean exercise capacity was 100% of predicted values, with 84% having normal capacity; no pulmonary hypertension or symptomatic arrhythmias were observed.
Conclusions:
- Surgical closure of ventricular septal defects in infancy and childhood leads to good long-term results.
- Health assessment and exercise capacity are comparable to the general population.
- Pulmonary hypertension is absent, despite potential residual sequelae.
Objectives:
The purpose of this study was to assess the health-related quality of life of patients who underwent surgical closure of a ventricular septal defect at a young age between 1968 and 1980.
Background:
Since the beginning of open heart surgery for congenital cardiac malformations, the surgical techniques have continually improved. As a result, even infants have become eligible for surgical repair. Long-term follow-up data are not available on the health-related quality of life of nonselected patients after surgical repair at a young age. We therefore conducted a follow-up study of 176 infants and children consecutively operated on in one institution between 1968 and 1980.
Methods:
Patients who were alive and could be traced through the offices of local registrars received an invitation to participate in the follow-up study, consisting of an interview, physical examination, echocardiography, exercise testing and standard 12-lead and 24-h electrocardiography.
Results:
One hundred nine patients (78% of those eligible for follow-up) participated. The mean interval after operation (+/- SD) was 14.5 +/- 2.6 years. Eighty-four percent of the patients assessed their health as good or very good, and 89% had been free of any medical or surgical intervention since the operation. At physical examination all patients were in good health. Their mean exercise capacity was 100 +/- 17% (range 56% to 141%) of predicted values; 84% of the patients had a normal exercise capacity. Echocardiography demonstrated a small residual ventricular septal defect in seven patients (6%). There were no signs of pulmonary hypertension. No patient had symptomatic arrhythmias.
Conclusions:
Long-term results of surgical closure of ventricular septal defect in infancy and childhood are good. Pulmonary hypertension is absent. Personal health assessment is comparable to that of the normal population, as is exercise capacity, even though many patients have anatomic, hemodynamic or electrophysiologic sequelae.