Ventricular Septal Defect in Adults: Associated Complications and Results of Surgery

Anton V. Minaev, Vladimir P. Podzolkov, Mikhail M. Zelenikin, Vera I. Dontsova, Inga V. Zemlyanskaya

A.N. Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russia

Date, time and location: 2018.05.26 17:00, Press Hall, 2F

Abstract

Objectives:The prolonged natural course of unoperated ventricular septal defects (VSD) in adults leads to complications that change the management of these patients. The need for a special approach to diagnosis and treatment in this group is actual.

The aim of the study is to determine the features of diagnosis and surgical treatment of VSD in adults; to present immediate and long-term results of VSD closure.

Methods:From 1998 to 2015, 162 adult patientsaged 28,4 ± 9.7 years inour center underwent VSD closure without any previous correction. VSD was perimembranous in 88,3%, subarterial in 9,3%, muscular in 1,2%, multiple in 1,2%. Atrial flutter was found in 4%, endocarditis – in 4%. Sinus of Valsalva aneurism rupture was noted in 8,8%, aortic regurgitation – in 9,6%, tricuspid regurgitation – in 5,6%, mitral regurgitation – in 4,2%, subaortic obstruction – in 3,3%, subvalvular pulmonary stenosis – in 9,7%.

Results:In 49,7% VSD was closed with a patch, in other patients VSD was sewed. Closure of sinus of Valsalva aneurism rupture was in 8,8%, aortic valve replacement – in 9,6%, tricuspid valve repair – in 5%, tricuspid valve replacement – in 0,6%, mitral valve repair – in 3,6%, mitral valve replacement – in 0,6%, correction of subaortic stenosis – in 3,3%, correction of subvalvular pulmonary stenosis – in 9,7%. 1 patient underwent CABG. In 72% there was no any associated complications. There was 1 early death due to arrhythmia. 2 patients underwent pacemaker implantation, another patients had uncomplicated hospital period. Survival at 5 years follow up was 100%, freedom from reoperation was 98,8%. 

Conclusions:VSD in adults, even small size, may cause to associated complications, such as arrhythmia, endocarditis or valvular insufficiency, that requires surgical correction. VSD closure in childhood is preferable.