ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
RISK FACTORS IN INFANT VENTRICULAR SEPTAL DEFECT SURGERY
Ahmet Şükrü MERCAN, Atilla SEZGİN, Tankut AKAY, Sait AŞLAMACI, *Kürşad TOKEL, *Birgül VARAN, *Arda SAYGILI
Başkent Üniversitesi Tıp Fakültesi, Kalp Damar Cerrahisi Ana Bilim Dalı, Ankara

*Başkent Üniversitesi Tıp Fakültesi, Pediyatrik Kardiyoloji Ana Bilim Dalı, Ankara

Background: Ventricular septal defect (VSD) closure is a routine procedure in infancy period in the current era. However, some factors still have a role in the postoperative morbidity and mortality.

Methods: From March 1997 to March 2001, 95 infants underwent open heart surgery for VSD closure. The mean age of the patients was 7.7 ± 3 months (1 to 12 months; median 8 months), and the mean weight of the patients was 5.9 ± 1.7 kg (2.4 to 10 kg; median 6 kg). The types of the VSD were muscular in 4 patients (4.2%), perimembraneous in 78 patients (82.1%), doubly committed subarterial in 6 patients (6.3%), and multiple in 7 patients (7.3%). Right atriotomy was used in 81 patients (85.2%) to close VSD, and right ventriculotomy was used for the rest. In 61 patients (64.2%), an associated anomaly was found. The mean aortic cross clamp and cardiopulmonary bypass times were 41.9 ± 14.3 min (20 to 95 min) and 64.5 ± 21.7 min (38 to 156 min), respectively.

Results: Five patients (5.2%) died during early postoperative period. In this group, 2 patients had doubly committed subarterial VSD, 2 patients had perimembraneous VSD, and the last patient had multiple VSD. The causes of death were rhythm problem, pulmonary hypertensive crisis, myocardial dysfunction, multiorgan failure, and necrotizing enterocolitis.

Conclusions: VSD closure even with repairing associated cardiac malformations during infancy is a safe procedure. Doubly committed subarterial or multiple VSD, and right ventriculotomy are still risk factors that affect the postoperative morbidity and mortality of the infants.

Keywords : Venticular septal defect, infact, cardiac surgery, heart failure
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