Primary surgical closure of large ventricular septal defects in small infants

Hardin, Joel T.; Muskett, Alan; Canter, Charles E.; Martin, Thomas C.; Spray, Thomas L.

doi:10.1016/0003-4975(92)90257-5

Cited by 39 publications

(21 citation statements)

References 15 publications

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“…Several reports have documented encouraging results of early repair of critical congenital heart defects in symptomatic neonates and infants rather than palliative operations13 and of primary surgical closure of large ventricular septal defects 1415 …”

Section: Discussionmentioning

confidence: 99%

Malnutrition and growth failure in cyanotic and acyanotic congenital heart disease with and without pulmonary hypertension

Varan

Tokel

Yılmaz

1999

Archives of Disease in Childhood

235

189

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Aim-To investigate the eVect of several types of congenital heart disease (CHD) on nutrition and growth. Patients and methods-The prevalence of malnutrition and growth failure was investigated in 89 patients with CHD aged 1−45 months. They were grouped according to cardiac diagnosis: group aP (n = 26), acyanotic patients with pulmonary hypertension; group ap (n = 5), acyanotic patients without pulmonary hypertension; group cp (n = 42), cyanotic patients without pulmonary hypertension; and group cP (n = 16), cyanotic patients with pulmonary hypertension. Information on socioeconomic level, parental education status, birth weight and nutrition history, number of siblings, and the timing, quality, and quantity of nutrients ingested during weaning period and at the time of the examination were obtained through interviews with parents. Results-There was no significant diVerence between groups in terms of parental education status, socioeconomic level, duration of breast feeding, and number of siblings (p > 0.05). Group cP patients ingested fewer nutrients for their age compared to other groups. 37 of the 89 patients were below the 5th centile for both weight and length, and 58 of 89 patients were below the 5th centile for weight. Mild or borderline malnutrition was more common in group aP patients. Most group cp patients were in normal nutritional state, and stunting was more common than wasting. Both moderate to severe malnutrition and failure to thrive were more common in group cP patients. Conclusion-Patients with CHD are prone to malnutrition and growth failure. Pulmonary hypertension appears to be the most important factor, and cyanotic patients with pulmonary hypertension are the ones most severely aVected. This study shows the additive eVects of hypoxia and pulmonary hypertension on nutrition and growth of children with CHD. (Arch Dis Child 1999;81:49-52)

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Section: Discussionmentioning

confidence: 99%

Malnutrition and growth failure in cyanotic and acyanotic congenital heart disease with and without pulmonary hypertension

Varan

Tokel

Yılmaz

1999

Archives of Disease in Childhood

235

189

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“…A comparison with other studies is difficult since study populations differ and complications are reported in differing degrees of detail. Hardin and colleagues reported an intraoperative complication rate of 4.2% in children who had surgery between 1986 and 1991, while major and minor postoperative complications occurred in 10.4% and 29.2%, respectively, of their patients 3. We found no significant differences in the number of perioperative complications when we compared children with large and small VSDs in later years (15% and 16%, respectively); however, postoperative complications were significantly more common in children with large VSDs than in children with small VSDs during the same time period (39% and 15%, respectively, p < 0.005).…”

Section: Discussionmentioning

confidence: 99%

“…No controversy exists regarding early closure of an unrestrictive VSD in order to avoid pulmonary vascular obstructive disease,3 22-24 but surgical closure of a restrictive VSD in an asymptomatic patient with a modest or even small shunt is more controversial 425 26 The deliberate change toward more liberal indications for VSD closure in our institution, exemplified by the increased number of children with restrictive VSD and small or modest shunts (Qp:Qs 1.5 to 1.99) in the latter part of the study (table 2), was largely based on significant haemodynamic abnormalities at rest and exercise in a long term follow up study of untreated patients with a restrictive VSD 27…”

Section: Discussionmentioning

confidence: 99%

Preoperative evaluation and surgery in isolated ventricular septal defects: a 21 year perspective

Nygren

Sunnegårdh

Berggren

2000

Heart

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Objective-To study short and long term results after surgical closure of isolated ventricular septal defects (VSDs) from 1976 to 1996, especially in relation to changes in preoperative evaluation during this period. Design-Retrospective study. Setting-Tertiary referral centre for paediatric cardiac care. Patients-All children under 18 years of age who had corrective surgery for VSD between 1976 and 1996. Main outcome measures-Preoperative evaluation, indications for surgery, diagnostic errors, and early and late results. Results-A significant decrease in the use of invasive preoperative studies in favour of non-invasive methods was found; from 1976 to 1990, a total of 109/110 patients had preoperative invasive study as compared to 43/167 from 1991 to 1996 (p < 0.001). Pulmonary hypertension in small children, without detailed information on Qp:Qs ratio, as well as small or modest shunts without pulmonary hypertension, were more frequent indications for surgery in recent years. Early mortality after surgery occurred in 10 patients, with a significantly lower mortality rate found between 1991 and 1996 than between 1976 and 1990 (0.6% v 8.2%, p < 0.001).Children with large VSDs experienced perioperative complications significantly less often between 1991 and 1996 than between 1976 and 1990 (16/105 v 28/96, p < 0.05). Diagnostic errors showed a tendency to decrease between the two time periods. No late deaths occurred. Conclusions-Significant reductions in early mortality, perioperative complications, and diagnostic mistakes were seen during the study period, even though less invasive diagnostic procedures were being performed.

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“…[1,2,[4][5][6][7][8] Gluteraldehit ile muamele edilmiş sığır perikardı yamalar ise, kalp kapağı, kondüit olarak kardiyak cerrahideki çeşitli kullanım yerlerindeki sonuçlarının mükemmele yakın olması, esnekliği, dayanıklılığı, fibrozis nedeni ile büzülme özelliğinin az olmasından dolayı GPBP'nin intrakardiyak defekt onarımında ideal yama olduğu düşünülmektedir. [8][9][10][11][12][13][14][15] Bu yama 0.5 mm kalınlıkta olmasına rağmen güvenilir dikiş olanağı sağlamakla [16] birlikte ameliyat esnasında karakteristik kullanım özelliklerine de sahiptir. Gluteraldehit ile muamele edilmiş sığır perikardı yamalarının implantasyon sonrası dikiş hattındaki küçük kanamalar, vasküler cerrahide kullanılan otojen ven yamalarına benzemekte ve diğer sentetik yama materyalinden daha az görül-mektedir.…”

Section: Discussionunclassified

A comparison between the bovine pericardial and Dacron patch in repair of intracardiac defects: the short and mid-term results

Yaliniz¹

2013

Turk Gogus Kalp Dama

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Primary surgical closure of large ventricular septal defects in small infants

Cited by 39 publications

References 15 publications

Malnutrition and growth failure in cyanotic and acyanotic congenital heart disease with and without pulmonary hypertension

Malnutrition and growth failure in cyanotic and acyanotic congenital heart disease with and without pulmonary hypertension

Preoperative evaluation and surgery in isolated ventricular septal defects: a 21 year perspective

A comparison between the bovine pericardial and Dacron patch in repair of intracardiac defects: the short and mid-term results

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