Surgical Closure of Ventricular Septal Defect in the First Year of Life: Forty-Three Consecutive Successful Cases

KIYOSHI HANEDA; EIJI ISHIZAWA; SHIGEO YAMAKI; TAKASHI ITOH; TOGO HORIUCHI; HITOSHI MOHRI; HIROSHI OGATA

doi:10.1620/tjem.156.39

KIYOSHI HANEDA, EIJI ISHIZAWA, SHIGEO YAMAKI, TAKASHI ITOH, TOGO HORIUCHI, HITOSHI MOHRI, HIROSHI OGATA

Author information

Keywords: VSD, open heart surgery in infants, combined surface/perfusion hypothermia, total circulatory arrest

JOURNAL FREE ACCESS

1988 Volume 156 Issue 1 Pages 39-45

DOI https://doi.org/10.1620/tjem.156.39

Details

Published: 1988 Received: March 25, 1988 Available on J-STAGE: August 31, 2006 Accepted: August 12, 1988 Advance online publication: - Revised: -
Correction information
Date of correction: August 31, 2006 Reason for correction: - Correction: DTRECEIVED Details: Wrong : 19880525
Right : 19880325

Date of correction: August 31, 2006 Reason for correction: - Correction: ABSTRACT Details: Wrong : HANEDA, K., ISHIZAWA, E., YAMAKI, S., ITOH, T., HORIUCHI, T., MOHRI, H. and OGATA, H. Surgical Closure of Ventricular Septal Defect in the First Year of Life: Forty-Three Consecutive Successful Cases. Tohoku J. exp. Med., 1988, 156 (1), 39-45-Forty-three infants (less than 12 months of age) underwent VSD closure without operative mortality between June 1982 and December 1987. Average age and body weight at the operation were 6.9 months and 5.3kg, respectively. Associated cardiac anomalies were PDA (11 patients), ASD (5) and PS (1). Preoperative pulmonary to systemic peak pressure ratio (Pp/Ps), resistance ratio and flow ratio, and pulmonary vascular resistance were 0.79±0.15, 0.29±0.16, 2.52 ±0.60 and 3.05±1.94 unit•m2, respectively. VSD was closed under combined surface/perfusion hypothermia with total circulatory arrest in 25 patients and standard cardiopulmonary bypass in 18. All patients were discharged from the hospital in good condition, but there was one late death due to pneumonia. Postoperative Pp/Ps decreased to 0.39±0.11. Most of the patients demonstrated satisfactory body weight gain after VSD closure. These results support our current policy of aggressive surgical intervention for refractory VSD in the early stage of life.
Right : Forty-three infants (less than 12 months of age) underwent VSD closure without operative mortality between June 1982 and December 1987. Average age and body weight at the operation were 6.9 months and 5.3 kg, respectively. Associated cardiac anomalies were PDA (11 patients), ASD (5) and PS (1). Preoperative pulmonary to systemic peak pressure ratio (Pp/Ps), resistance ratio and flow ratio, and pulmonary vascular resistance were 0.79±0.15, 0.29±0.16, 2.52±0.60 and 3.05±1.94 unit•m², respectively. VSD was closed under combined surface/ perfusion hypothermia with total circulatory arrest in 25 patients and standard cardiopulmonary bypass in 18. All patients were discharged from the hospital in good condition, but there was one late death due to pneumonia. Postoperative Pp/Ps decreased to 0.39±0.11. Most of the patients demonstrated satisfactory body weight gain after VSD closure. These results support our current policy of aggressive surgical intervention for refractory VSD in the early stage of life.

Date of correction: August 31, 2006 Reason for correction: - Correction: AFFILIATION Details: Wrong :
1) Department of Thoracic and Cardiovascular Surgery
2) Department of Pediatrics, Tohoku University School of Medicine

Right :
1) Department of Thoracic and Cardiovascular Surgery, Tohoku University School of Medicine
2) Department of Pediatrics, Tohoku University School of Medicine

Date of correction: August 31, 2006 Reason for correction: - Correction: CITATION Details: Wrong : 1) Alexi-Meskhishvili, V.V., Nikoljuk, A.P., Churkin, V.M. & Abdurachimov, Z.Z. (1985) Deep hypothermia with reduced flow rates for correction of ventricular septal defects in infants. An alternative approach. Thorac. cardiavasc. Surgeon, 33, 157-161.
2) Arciniegas, E., Farooki, Z.Q., Hakimi, M., Perry, B.L. & Green, E.W. (1980) Surgical closure of ventricular septal defect during the first twelve months of life. J. thorac. cardiovasc. Surg, 80, 921-928.
3) Borst, H.G. & Iversen, S. (1980) Myocardial temperatures in clinical cardioplegia. Thorac. cardiovasc. Surgeon, 28, 29-33.
4) Bull, C., Cooper, J. & Stark, J. (1984) Cardioplegic protection of the child's heart. J. thorac. cardiovasc. Surg., 88, 287-293.
5) Crupi, G., Ferrazzi, P., Salomone, G., Mazza, E., Bianchi, T. & Parenzan, L. (1986) Surgical treatment of ventricular septal defect in the first two years of life. Alabama J. med. Sci., 23, 163-169.
6) Haneda, K., Sato, S., Ishizawa, E. & Horiuchi, T. (1985) The importance of colloid osmotic pressure during open heart surgery in infants. Tohoku J. exp. Med., 147, 65-71.
7) Haworth, S.G., Sauer, U., Bühlmeyer, K. & Reid, L. (1977) Development of the pulmonary circulation in ventricular septal defect. A quantitative structural study. Amer. J. Cardiol., 40, 781-788.
8) Heath, D. & Edwards, J.E. (1958) The pathology of hypertensive pulmonary vascular disease. A description of six grades of structural changes in the pulmonary arteries with special reference to congenital cardiac septal defects. Circulation, 18, 533-547.
9) Henze, A., Koul, B.L., Wallgren, G., Settergren, G. & Björk, V.O. (1984) Repair of ventricular septal defect in the first year of life. Scand. J. thorac. cardiovasc. Surg., 18, 151-154.
10) Horiuchi, T., Koyamada, K., Matano, I., Mohri, H., Komatsu, T., Honda, T., Abe, T., Ishitoya, T., Sagawa, Y., Matsuzawa, K., Matsumura, M., Tsuda, T., Ishizawa, E., Ishikawa, S., Suzuki, H. & Saito, Y. (1963) Radical operation for ventricular septal defect in infancy. J. thorac. cardiovasc. Surg., 46, 180-190.
11) Jarmakani, J.M.M., Graham, T.P., Jr., Canent, R.V., Jr. & Capp, M.P. (1971) The effect of corrective surgery on left heart volume and mass in children with ventricular septal defect. Amer. J. Cardiol., 27, 254-258.
12) Rein, J.G., Freed, M.D., Norwood, W.I. & Castaneda, A.R. (1977) Early and late results of closure of ventricular septal defect in infancy. Ann. thorac. Surg., 24, 19-27.
13) Schachner, A., Vladutiu, A., Montes, M., Koreyni-Both, A., Levinsky, L., Levy, M.J. & Subramanian, S. (1983) Myocardial protection in infant open heart surgery. Scand. J. thorac. cardiovasc. Surg., 17, 101-107.
14) Singh, A.K., Corwin, R.D., Teplitz, C. & Karlson, K.E. (1984) Consecutive repair of complex congenital heart disease using hypothermic cardioplegic arrest. Its results and ultrastructural study of the myocardium. Thorac. cardiovasc. Surgeon, 32, 23-26.
15) Soto, B., Becker, A.E., Moulaert, A.J., Lie, J.T. & Anderson, R.H. (1980) Classification of ventricular septal defects. Brit. Heart J., 43, 332-343.
16) Voríšková, M., Hucín, B., Fišer, B., Kopecká, L., Chaloupecký, V., Hrobonová, V., Bartáková, H. & Šamánek, M. (1984) Results of radical surgical correction of ventricular septal defect. Cor Vasa, 26, 161-166.
17) Yamaki, S. & Tezuka, F. (1976) Quantitative analysis of pulmonary vascular disease in complete transposition of the great arteries. Circulation, 54, 805-809.
18) Yeager, S.B., Freed, M.D., Keane, J.F., Norwood, W.I. & Castaneda, A.R. (1984) Primary surgical closure of ventricular septal defect in the first year of life. Results in 128 infants. J. Amer. Coll. Cardiol., 3, 1269-1276.

Right : 1) Alexi-Meskhishvili, V. V., Nikoljuk, A. P., Churkin, V. M. & Abdurachimov, Z. Z. (1985) Deep hypothermia with reduced flow rates for correction of ventricular septal defects in infants. An alternative approach. Thorac. cardiovasc. Surgeon, 33, 157-161.
2) Arciniegas, E., Farooki, Z. Q., Hakimi, M., Perry, B. L. & Green, E. W. (1980) Surgical closure of ventricular septal defect during the first twelve months of life. J. thorac. cardiovasc. Surg, 80, 921-928.
3) Borst, H. G. & Iversen, S. (1980) Myocardial temperatures in clinical cardioplegia. Thorac. cardiovasc. Surgeon, 28, 29-33.
4) Bull, C., Cooper, J. & Stark, J. (1984) Cardioplegic protection of the child's heart. J. thorac. cardiovasc. Surg., 88, 287-293.
5) Crupi, G., Ferrazzi, P., Salomone, G., Mazza, E., Bianchi, T. & Parenzan, L. (1986) Surgical treatment of ventricular septal defect in the first two years of life. Alabama J. med. Sci., 23, 163-169.
6) Haneda, K., Sato, S., Ishizawa, E. & Horiuchi, T. (1985) The importance of colloid osmotic pressure during open heart surgery in infants. Tohoku J. exp. Med., 147, 65-71.
7) Haworth, S. G., Sauer, U., Bühlmeyer, K. & Reid, L. (1977) . Development of the pulmonary circulation in ventricular septal defect. A quantitative structural study. Amer. J. Cardiol., 40, 781-788.
8) Heath, D. & Edwards, J. E. (1958) The pathology of hypertensive pulmonary vascular disease. A description of six grades of structural changes in the pulmonary arteries with special reference to congenital cardiac septal defects. Circulation, 18, 533-547.
9) Henze, A., Koul, B. L., Wallgren, G., Settergren, G. & Björk, V. O. (1984) Repair of ventricular septal defect in the first year of life. Scand. J. thorac. cardiovasc. Surg., 18, 151-154.
10) Horiuchi, T., Koyamada, K., Matano, I., Mohri, H., Komatsu, T., Honda, T., Abe, T., Ishitoya, T., Sagawa, Y., Matsuzawa, K., Matsumura, M., Tsuda, T., Ishizawa, E., Ishikawa, S., Suzuki, H. & Saito, Y. (1963) Radical operation for ventricular septal defect in infancy. J. thorac. cardiovasc. Surg., 46, 180-190.
11) Jarmakani, J. M. M., Graham, T. P., Jr., Canent, R. V., Jr. & Capp, M. P. (1971) The effect of corrective surgery on left heart volume and mass in children with ventricular septal defect. Amer. J. Cardiol., 27, 254-258.
12) Rein, J. G., Freed, M. D., Norwood, W. I. & Castaneda, A. R. (1977) Early and late results of closure of ventricular septal defect in infancy. Ann. thorac. Surg., 24, 19-27.
13) Schachner, A., Vladutiu, A., Montes, M., Koreyni-Both, A., Levinsky, L., Levy, M. J. & Subramanian, S. (1983) Myocardial protection in infant open heart surgery. Scand. J. thorac, cardiovasc. Surg., 17, 101-107.
14) Singh, A. K., Corwin, R. D., Teplitz, C. & Karlson, K. E. (1984) Consecutive repair of complex congenital heart disease using hypothermic cardioplegic arrest. Its results and ultrastructural study of the myocardium. Thorac. cardiovasc. Surgeon, 32, 23-26.
15) Soto, B., Becker, A. E., Moulaert, A. J., Lie, J. T. & Anderson, R. H. (1980) Classification of ventricular septal defects. Brit. Heart J., 43, 332-343.
16) Voríšková, M., Hucín, B., Fišer, B., Kopecká, L., Chaloupecký, V., Hrobonová, V., Bartáková, H. & Šamánek, M. (1984) Results of radical surgical correction of ventricular septal defect. Cor Vasa, 26, 161-166.
17) Yamaki, S. & Tezuka, F. (1976) Quantitative analysis of pulmonary vascular disease in complete transposition of the great arteries. Circulation, 54, 805-809.
18) Yeager, S. B., Freed, M. D., Keane, J. F., Norwood, W. I. & Castaneda, A. R. (1984) Primary surgical closure of ventricular septal defect in the first year of life. Results in 128 infants. J. Amer. Coll. Cardiol., 3, 1269-1276.

Date of correction: August 31, 2006 Reason for correction: - Correction: PDF FILE Details: -

Abstract

Forty-three infants (less than 12 months of age) underwent VSD closure without operative mortality between June 1982 and December 1987. Average age and body weight at the operation were 6.9 months and 5.3 kg, respectively. Associated cardiac anomalies were PDA (11 patients), ASD (5) and PS (1). Preoperative pulmonary to systemic peak pressure ratio (Pp/Ps), resistance ratio and flow ratio, and pulmonary vascular resistance were 0.79±0.15, 0.29±0.16, 2.52±0.60 and 3.05±1.94 unit•m², respectively. VSD was closed under combined surface/ perfusion hypothermia with total circulatory arrest in 25 patients and standard cardiopulmonary bypass in 18. All patients were discharged from the hospital in good condition, but there was one late death due to pneumonia. Postoperative Pp/Ps decreased to 0.39±0.11. Most of the patients demonstrated satisfactory body weight gain after VSD closure. These results support our current policy of aggressive surgical intervention for refractory VSD in the early stage of life.

Corresponding author

Correction information

Register with J-STAGE for free!