Original articleCardiovascularSpontaneous Closure of Small Residual Ventricular Septal Defects After Surgical Repair
Section snippets
Material and Methods
The Institutional Review Board of our hospital approved the study. Retrospective chart and echocardiography report analysis were anonymously performed, whereby patient consent was waived. Between 1994 and 2005, 198 consecutive patients underwent surgery for closure of an isolated perimembranous VSD (n = 100), a malalignment TOF VSD (n = 52), or an inlet AVSD (n = 46). Standard surgical technique using cardiopulmonary bypass with moderate hypothermia, cross-clamping, and cold blood cardioplegia
Results
Median follow-up was 3.1 years (range, 0.5 to 9.7 years), and was similar in all three diagnostic groups. Discrepancy was observed between the intraoperative TEE findings and those of the first TTE performed in the intensive care unit, either on the same day as the operation or one day afterward. As seen in Table 1, the first TTE on the ICU disclosed a 30% rate of residual VSD versus only 20% on intraoperative TEE in patients after AVSD repair; 46% versus 15% after repair of tetralogy, and 30%
Comment
Surgical closure of an isolated VSD is a routinely performed operation, using standardized surgical techniques and postoperative care management. Outcomes are excellent, with mortality and morbidity rates approaching zero in almost all centers internationally [1]. When a VSD is part of a more complex congenital heart disease, such as tetralogy of Fallot or complete atrioventricular septal defect, they are routinely closed, with surgical mortalities ranging from 1% to 5% and 3% to 16%,
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