Clinical Implications of a Multivariate Stratification Model for the Estimation of Prognosis in Ventricular Septal Defect

Danford, David A.; Martin, Ameeta B.; Danford, Christopher J.; Kaul, Sheetal; Marshall, Amanda M.; Kutty, Shelby

doi:10.1016/j.jpeds.2015.04.005

Cited by 3 publications

(1 citation statement)

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“…Estimation of the prognosis in congenital heart diseases including VSD is of great value to patients, their families, and the physicians. Information about the prognostic predictors of outcomes helps to make realistic expectations, optimizes patients’ selection for surgery, and provides a standard for comparing the outcomes of different proposed therapies [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Predictors of major adverse events and complications after ventricular septal defects surgical closure in children less than 10 kg

Abdelrehim

Al-Muhaya

Alkodami

et al. 2022

J Cardiothorac Surg

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Background Ventricular septal defect (VSD) is the most common congenital cardiac defect for which outcomes are not uniform. There is a lack of consensus on the risk factors for the unfavorable outcomes following surgical VSD closure. Aim The aim of this study was to determine the risk factors and the predictors of major adverse events (MAEs) and complications following surgical closure of VSD in children weighing less than 10 kg. Methods This retrospective cohort study included children less than 10 kg who underwent surgical closure of congenital VSD of any type with or without associated congenital heart diseases. Patients with associated major cardiac anomalies were excluded. Preoperative, operative and postoperative data were collected from medical records. Results This study included 127 patients 52.8% were males, the median age was 8.0 months (IQR = 6.0–11.0 months), and their median weight was 5.7 kg (IQR = 4.8–7.0). Mortality was in one patient (0.8%) Multivariable logistic regression analysis revealed that male sex group (observational data), previous pulmonary artery banding (PAB), and significant intraoperative residual VSD were significant risk factors for the development of MAEs (odds ratios were 3.398, 14.282, and 8.634, respectively). Trisomy 21 syndrome (odds ratio: 5.678) contributed significantly to prolonged ventilation. Pulmonary artery banding (odds ratio: 14.415), significant intraoperative (3 mm) residual VSD (odds ratio: 11.262), and long cross-clamp time (odds ratio: 1.064) were significant predictors of prolonged ICU stay, whereas prolonged hospital stay was observed significantly in male sex group (odds ratio: 12.8281), PAB (odds ratio: 2.669), and significant intraoperative (3 mm) residual VSD (odds ratio: 19.551). Conclusions Surgical VSD repair is considered a safe procedure with very low mortality. Trisomy 21 was a significant risk factor for prolonged ventilation. Further, PAB, significant intraoperative residual of 3 mm or more that required a second pulmonary bypass, and a greater cross-clamp time were significant predictors of MAE and associated complications with prolonged ICU and hospital stay.

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Section: Introductionmentioning

confidence: 99%