Surgical closure of ventricular septal defect in adults: A multicenter study - 05/01/18
Résumé |
Background |
Although ventricular septal defect (VSD) is one of the most common congenital heart disease, this defect is not so frequent in adults because of early surgery and spontaneous closure. Complications such as aortic insufficiency, infectious endocarditis or supraventricular arrhythmia are classically described.
Purpose |
The main objective of this study was to determine the outcome of adult patients who were operated for VSD after childhood.
Methods |
We conducted an observational, retrospective and multicenter study including patients operated for VSD from the age of 18 years, over a 15-year period (2000–2015). Overall survival and occurrence of adverse events were analyzed.
Results |
Seventy-three patients were included. Mean age was 37.47±2.1 years with a male predominance (62%). Type 2 VSDs were the most common type encountered. After surgery, overall survival was 92% with a mean follow-up of 6 years. Excluding events occurring during the early postoperative period, overall survival was significantly better in patients operated for isolated VSD than in patients operated for VSD associated with other cardiac injuries (95% versus 92%, P=0.02). Early postoperative complications were found in 14% of patients (principally atrioventricular block requiring early postoperative permanent pacing). Aortic cross clamp and cardiopulmonary bypass time were significantly lower in patients operated for isolated VSD than in patients with associated lesion.
Conclusion |
As morbi-mortality is low, surgical closure of VSD in adults is not a high-risk intervention. Survival of patients with isolated VSD is better than that of patients with associated cardiac lesions. This last finding advocates for early surgery before the apparition of complications.
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Vol 10 - N° 1
P. 133 - janvier 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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