@Article{chd.2024.045137,
AUTHOR = {Jae Hong Lee, Sungkyu Cho, Jae Gun Kwak, Hye Won Kwon, Woong-Han Kim, Mi Kyoung Song, Sang-Yun Lee, Gi Beom Kim, Eun Jung Bae},
TITLE = {Surgical Repair of Ventricular Septal Defect in Neonates: Indications and Outcomes},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {19},
YEAR = {2024},
NUMBER = {1},
PAGES = {69--83},
URL = {http://www.techscience.com/schd/v19n1/55772},
ISSN = {3071-1738},
ABSTRACT = { <b>Background:</b> 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). <b>Methods:</b> 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. <b>Results:</b> 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 (<i>p</i> < 0.001) and a longer length of intensive care unit stay (<i>p</i> < 0.001). <b>Conclusions:</b> 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.},
DOI = {10.32604/chd.2024.045137}
}