Open Access
ARTICLE
Surgical Repair of Ventricular Septal Defect in Neonates: Indications and Outcomes
Jae Hong Lee1, Sungkyu Cho2,*, Jae Gun Kwak2, Hye Won Kwon2, Woong-Han Kim2, Mi Kyoung Song3, Sang-Yun Lee3, Gi Beom Kim3, Eun Jung Bae3
1 Department of Thoracic and Cardiovascular Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
2 Department of Thoracic and Cardiovascular Surgery, Seoul National University Children’s Hospital, Seoul, Korea
3 Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, Korea
* Corresponding Author: Sungkyu Cho. Email:
Congenital Heart Disease 2024, 19(1), 69-83. https://doi.org/10.32604/chd.2024.045137
Received 18 August 2023; Accepted 23 January 2024; Issue published 20 March 2024
Abstract
Background: The optimal surgical timing and clinical outcomes of ventricular septal defect (VSD) closure in neonates remain unclear. We aimed to evaluate the clinical outcomes of VSD closure in neonates (age ≤ 30 days).
Methods: We retrospectively reviewed 50 consecutive neonates who underwent VSD closure for isolated VSDs between August 2003 and June 2021. Indications for the procedure included congestive heart failure/failure to thrive and pulmonary hypertension. Major adverse events (MAEs) were defined as the composite of all-cause mortality, reoperation, persistent atrioventricular block, and significant (≥grade 2) valvular dysfunction.
Results: The median age and body weight at operation were 26.0 days (interquartile range [IQR], 18.8–28.3) and 3.7 kg (IQR, 3.3–4.2), respectively. The median follow-up duration was 110.4 months (IQR, 56.8–165.0). Seven patients required preoperative respiratory support, and five had significant (≥grade 2) preoperative valvular dysfunction. One early mortality occurred due to irreversible cardiogenic shock; no late mortality was observed. One reoperation was due to hemodynamically significant residual VSD at 103.8 months postoperatively. The overall survival, freedom from reoperation, and freedom from MAE at 15-years were 98.0%, 96.3%, and 94.4%, respectively. Preoperative mechanical ventilation was associated with a longer duration of postoperative mechanical ventilation (
p < 0.001) and a longer length of intensive care unit stay (
p < 0.001).
Conclusions: VSD closure with favorable outcomes without morbidities is feasible even in neonates. However, neonates requiring preoperative respiratory support may require careful postoperative management considering the long-term postoperative risks. Overall, surgical VSD closure might be indicated earlier in neonates with respiratory compromise.
Keywords
Cite This Article
Lee, J. H., Cho, S., Kwak, J. G., Kwon, H. W., Kim, W. et al. (2024). Surgical Repair of Ventricular Septal Defect in Neonates: Indications and Outcomes.
Congenital Heart Disease, 19(1), 69–83. https://doi.org/10.32604/chd.2024.045137