All issues > Volume 39(1); 1996

Original Article

J Korean Pediatr Soc. 1996;39(1):72-77. Published online January 15, 1996.

Early Postoperative Results of the Large Ventricular Septal Defect in Infants Younger Than 1 Year of Age

Man-Teak MT Oh¹, Hyang-Suk HS Yoon¹, Jong-Bum JB Choi²

¹Department of Pediatrics, Wonkwang University, School of Medicine, Iksan, Korea
²Department of Thoracic and Cardiovascular Surgery, Wonkwang University,School of Medicine, Iksan, Korea

Abstract

Purpose
: We report the results of a policy of primary surgical closure of large ventricular septal defects(VSDs) applied over the past 3 years to all symptomatic infants regardless of patient weight, location or number of VSDs. To analyze the early postoperative mortality and other surgical complications in young infants, comparison of preoperative and outcome variables were made between infants weighing 6 kg or less and those weighing mort than 6 kg at the time of operation.
Methods
: Forty-eight infants met criteria for inclusion in the study, and were divided into two groups based on body weight: group 1 infants weighed 6 kg or less(n=24), and group 2 infants weighed more then 6 kg(n=24). Both groups had similar variation in ventricular septal defect location and the ratio of the flow. resistance.
Results
: The major associated cardiac defects were more in group 1. The overall mortality rate of this study was 4%(2/48): Two early deaths occurred in only group 1(8%). Both infants had a doubly committed subarterial defect and mild degree of coarctation of aorta (one was a preductal type). One received a coatctation-repari. There was o only one patch dehiscence(in group 1). No surviving patients required a second ventricular septal defect opetation, and the majority no longer received anticongestive therapies.
Conclusion
: These results indicate that primary surgical closure of large ventricular septal defects can be performed in small infants with no difference in mortality or serious complication rates compared with larger infants. Protracted medical efforts to achieve larger size before primary repair and palliative pulmonary artery banding are not necessary.

Keywords :Ventricular Septal Defect, Small Infant, Postoperative Result