Ventricular septal defect repair in children during first year of life in a public hospital

Objective. Ventricular septal defect (VSD) is the most common congenital heart disease; primary surgical closure is the usual strategy for repairing it. Our objective is to describe results of surgical repair in children under 1 year of age and analyze risk factors for morbidity and mortality. Patients and Methods. Retrospective study; all patients with VSD repaired between 2004 and 2011 were included. Demographic, surgical procedure and postoperative variables were recorded: age, weight, genetic syndrome, type of VSD, length of stay, complications and outcome. Risk factors of mortality and morbidity: age < 6 m, weight < 3 kg, Down, malnutrition and respiratory infection prior syndrome were analyzed. Results. 256 patients, age 5.3 months (21d-1y), weight 4.75 kg (2.2 to 13), 32% with Down syndrome and 17.5% with preoperative mechanical ventilation were operated. Perimembranous VSD was the most frequent type (62%). 28% experienced complications and 7% required reoperation for bleeding, infection or defect. The median hospital stay was 6 days (1-185). Postoperative 30 days mortality was 3%. Age < 6 m, weight < 3 kg, malnutrition and prior respiratory viral infection were associated with prolonged hospitalization, but no risk factors for mortality were identified. Conclusion. The primary surgical closure of the VSD is a procedure with satisfactory results at our institution.