Small Ventricular Septal Defect Considered Not Requiring Surgical Closure: The Frequency of Developing Complications in Our Center

Abstract

Objectives:The study was conducted to check the frequency of development of complication in the patients with small Ventricular Septal Defects (VSDs) considered not requiring surgical closure during childhood. Methods: A descriptive study was conducted on children from January 2015 to December 2015 at Children Hospital and Institute of Child Health, Lahore, Pakistan. The data with isolated VSDs considered too small to require surgery from 1 month to 15 years of age were reviewed. The data was analyzed with SPSS 20 version. Results: The total of 883 patients of restrictive VSDs considered not to require surgery, 60.6% (n=535) were males and 39.4% (n=348) were females. The significant number of patients i.e. 18.7% (n=166) developed complications. Aortic cusp prolapsed developed in 13.6% i.e. p≤0.05, 2.3% developed aortic regurgitation secondary to aortic cusp prolapsed. 1.8% developed right ventricular track outflow obstruction (RVOT) i.e. p≤0.05 and 0.3% of patient developed left ventricular outflow track obstruction (LVOT) i.e. p≤0.05. Similarly 0.8% patients developed endocarditis. Regarding types of VSD, we found Perimembranous in 65.8%, muscular in 12.6%, Subaorticin 8.3%, doubly committed in 6.0%, Inlet in 5% and outlet in 1.7% of our patients. Conclusions: Patients with small restrictive Ventricular Septal Defects (VSDs) generally been considered as do not required surgery, the data suggested that a significant percentage of these patients developed complications later in their life i.e., 18.7%.

Infective Endocarditis in Children with Isolated VSD: A Single Center Study

“…According to AHA guidelines and NICE guidelines VSD is considered as moderate to low risk for developing infective endocarditis, as per that only good dental hygiene and skin care rather antibiotic prophylaxis is sufficient to prevent IE. On the other hand, a study conducted in Lahore, Pakistan reported significant risk of IE with small VSD and recommended use of prophylactic antibiotics in patients with even small VSD 6 .…”