Outcome of VSD Surgery in Ibn Al-Nafees Teaching Hospital

Abstract

Overview
The presentation of unrepaired VSDs is largely dependent on the presence of hemodynamically significant
shunt. The murmur of VSD is typically pan-systolic best heard in the left lower sternal border; it is harsh
and loud in small defects but softer and less intense in large ones. (TTE) is the most valuable tool for
diagnosis due to its high sensitivity. Approximately 85% to 90% of small isolated VSDs close spontaneously
during the first year of life. Surgical repair reduces the risk for endocarditis, might improve PAH, and
overall, it increases survival.
Aim of the study: Is to evaluate the result of surgical closure of VSD in Ibn Al-Nafees teaching hospital.
Patients and methods: This is a retrospective study for surgically managed patients with ventricular septal
defect in single center done in cardiac center, Ibn Al-Nafees teaching hospital during the period from
January 2020 till December 2021. The documents of 50 patients were studied in our center during 2 years
only. Patients who met the criteria of the study were included. The other patients were excluded from the
study mainly those who had more complex cardiac anomalies, including tetralogy of Fallot, atrioventricular
septal defect and coarctation of aorta.
Result: The youngest patient was 3 year while the oldest one was 28 years. The mean age group was 15
years. The lowest body weight was 13 kg while the highest was 80 kg. Only 15 patients had cardiac
catheterization and most of them had other associated anomalies like ASD , aortic incompetence, subaortic
ridge , PS , etc.
86% of patients have had pulmonary hypertension from mild to moderate to severe degree while those with
PS protect the pulmonary circulation from pulmonary hypertension. The material of patch used was Dacron
patch for all cases. The shortest cross clamp time was 19 minutes while the longest was 125 minutes. The
shortest cardiopulmonary bypass time was 44 minutes while the longest time was 185 minutes. In our study
aortic valve prolapse and regurgitation was the most common associated anomalies present in 20% of the
patients. In our study 2 patients died.
Conclusion: Still we have adult congenital heart diseases like VSD or other congenital heart diseases which
become very rare in developed countries. Mortality rate of 4%. Although it is high than the standard which
is 0-1% in advanced cardiac centers.