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Date Published: 08/10/2021
Online Published: 14/10/2021
Abstract Views: 1020
Views PDF: 681
DOI: https://doi.org/10.47972/vjcts.v34i.614
Issue
Vol. 34
Section
Research Article
How to Cite
Thao, D. P., Chang, V. T., Tien, D. A., & Thuy, N. T. (2021). Surgical results for closure of ventricular septal defect with severe pulmonary hypertension in children at Cardiovascular Center - E hospital. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 34, 30-42. https://doi.org/10.47972/vjcts.v34i.614

Surgical results for closure of ventricular septal defect with severe pulmonary hypertension in children at Cardiovascular Center - E hospital

Dinh Phuong Thao, Vu Thi Chang, Do Anh Tien, Nguyen Tran Thuy

Main Article Content

Abstract

Objectives: To describe the characteristics of clinical manifestations, laboratory and evaluation early treatment results and after 3 months in children who underwent surgery for Ventricular septal defect (VSD) closed - severe pulmonary hypertension (PH) at Cardiovascular Center – E Hospital.


Subjects   and   Methods: A prospective and retrospective descriptive study on 60 patients diagnosed with VSD – severe pulmonary hypertension at Cardiovascular Center – E Hospital from 8/2018 to 3/2021.


Results: 60 patients in the study, 59 patients underwent surgery, the mean age was 8.98 months, the average weight was 5.49 kg. 57 patients (95.0%) grade II-III heart failure before surgery, 43 patients (71.7%) with moderate to severe malnutrition. The mean preoperative pulmonary artery pressure (PAP) was 71.53 ± 9.42 mmHg (60 – 90 mmHg). Average size of VSD was 9.23 ± 3.32 (6 - 20mm). Cardiopulmonary bypass/ the aortic cross-clamp times was 67,8 ± 24,5/ 44,3 ± 20,4 minutes. There was 1 early deaths (1,7%), 14 (23,7%) with residual shunt, 15 patients (25.4%) with right bundle branch block, 1 patient (1.7%) AV block III requires a pacemaker. PAP after surgery was 30.81 ± 11.01 (15 - 70 mmHg).


Follow-up after surgery for an average of 3 months: there was no late death, PAP at follow-up was 22.36 ± 7.83 (15 - 50 mmHg). The group of children operated before 12 months, the percentage of patients PAP value returned to normal higher than the group of children operated after 12 months (89.6% vs 50.0%), statistical  significance at  p < 0,05. There were 53 patients with heart failure grade I (94, 6%) and 41 patients (73.2%) had normal weight for age at the time of re-examination.


Conclusion: The surgery VSD closed is the most thorough and optimal treatment method for VSD with severe PH. Our study showed a good outcome after surgery, the success rate was 98.3%, the frequency of complications was low and all were detected and treated promptly. In the group of children operated before 12 months, the percentage of patients PAP value returned to normal higher than the group of children operated after 12 months.

Article Details

Keywords

Ventricular septal defect, severe pulmonary hypertension, outcomes after congenital heart surgery, 60 children, Cardiovascular Center - E hospital

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