Outcome of ventricular septal defect repair in a developing country.
OBJECTIVE
To examine the impact of nutrition and lung infection on outcome early after ventricular septal defect (VSD) repair in infants in a developing country.


METHODS
One hundred consecutive infants (age, 7.4 +/- 3.3 months) with large VSD(s) who underwent surgical repair at one institution in South India from July 1998 to June 2000 were analyzed. Primary outcome variables were postoperative death, duration of mechanical ventilation, intensive care unit (ICU) stay, and hospital stay. Preoperative variables analyzed included age, weight and length Z scores, and lung infection.


RESULTS
Preoperative nutrition was poor (weight Z score, -2.8 +/- 1.3), and 25 patients had pneumonia. Six patients died after repair. No preoperative variable was associated with death. Mechanical ventilation, ICU stay, and hospital stay were longer for younger patients (r (s) for ventilation, -0.23, P =.02; for ICU stay, -0.33, P <.001; for hospital stay, -0.27, P =.007) and for those with preoperative pneumonia (median ventilation duration, 46 vs 24 hours, P <.001; median ICU stay 7 vs 4 days, P <.001; median hospital stay 10 vs 7 days, P =.001). Preoperative weight and length Z scores were not associated with any outcome variable.


CONCLUSIONS
Poor nutritional status, preoperative pneumonia, and age do not increase mortality rates after VSD repair. Repair of large VSDs should not be delayed because of these preoperative characteristics.
Vaidyanathan
Balu
B
Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
Roth
Stephen J
SJ
Rao
Suresh G
SG
Gauvreau
Kimberlee
K
Shivaprakasha
Krishnanaik
K
Kumar
R Krishna
RK
D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D007194:India; D007223:Infant; D007902:Length of Stay; D008297:Male; D009752:Nutritional Status; D011014:Pneumonia / Q000150:complications; D012121:Respiration, Artificial; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome