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The Journal of Thoracic and Cardiovascular Surgery, Vol 80, 485-493, Copyright © 1980 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
JK Kirklin, AR Castaneda, JF Keane, KE Fellows and WI Norwood
Between Jan. 1, 1973, and June 1, 1979, 29 patients underwent surgical
closure of multiple ventricular septal defects (VSDs). Included are 19
patients with VSDs only (one death), five with tetralogy of Fallot (TF) (0
deaths), two with transposition of the great arteries and VSD (TGA/VSD)
(one death), two with complete atrioventicular (AV) canal (one death), and
one with common atrium (one death). The overall hospital mortality rate was
14% (4/29) and was significantly related to the complexity of the
underlying malformation (p = 0.01) and the presence of major associated
cardiac lesions (p = 0.005). The incidence of reoperation for overlooked
VSDs was 28% (8/29) and was significantly related to the presence of
muscular VSDs (all overlooked defects were muscular) and the failure
preoperatively to diagnose multiple VSDs (p = 0.05). Of patients with shunt
data available after the final operation, 85% (17/20) had a Qp/Qs less than
or equal to 1.5, and no patient had a final Qp/Qs > 2.0. This experience
indicates that satisfactory results usually can be achieved after operation
for multiple VSDs and emphasizes the value of early assessment for residual
shunting and reoperation when indicated.
ARTICLES
Surgical management of multiple ventricular septal defects
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