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Ann Thorac Surg 1977;24:19-27
© 1977 The Society of Thoracic Surgeons

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Articles

Early and Late Results of Closure of Ventricular Septal Defect in Infancy

From the Departments of Cardiovascular Surgery and Cardiology, The Children's Hospital Medical Center, and Departments of Surgery and Pediatrics, Harvard Medical School, Boston, MA

^* Address reprint requests to Dr. Castaneda, Department of Cardiovascular Surgery, Children's Hospital Medical Center, 300 Longwood Ave, Boston, MA 02115

Fifty infants ranging in age from 13 days to 18 months (mean age 6 months) and weighing from 1.7 to 8.2 kg (mean weight 4.5 kg) underwent patch closure of a ventricular septal defect (VSD) with use of deep hypothermic circulatory arrest. Seventeen infants were under 3 months of age. The principal indication for operation was intractable chronic congestive heart failure. All infants were below the third percentile for weight preoperatively. Three patients (6%) died postoperatively within the second month of life. There was no late mortality. Seven infants (14%) had seizures; these were associated with a low output state in 2 infants, with hypoxic episodes in 4 infants, and occurred postoperatively in 1 infant. Postoperatively, 8 (17%) of the surviving infants developed right bundle-branch block and left anterior hemiblock, and 16 (32%) developed right bundle-branch block alone. One year postoperatively, catheterization studies in 24 children revealed normal pulmonary artery pressure and pulmonary vascular resistance in all; there were no significant residual ventricular septal defects. Because of these results we continue to be enthusiastic about primary closure of VSD irrespective of age or weight.

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