title: Outcome of patients after surgical closure of ventricular septal defect at young age: longitudinal follow-up of 22-34 years.
abstract: BACKGROUND
  Long-term survival and clinical outcome after surgical closure of a VSD is poorly documented. Such data are important for the future perspectives, medical care, employability, and insurability of these patients.
  
  
  METHODS
  176 consecutive patients underwent surgical closure of an isolated VSD between 1968 and 1980 in our hospital. A systematic follow-up study was performed in 1990 and again in 2001.
  
  
  RESULTS
  Late survival was poorer than in the general population. Pulmonary hypertension and right ventricular hypertrophy were present in the 4 patients who died suddenly, late after operation. During follow-up no new pulmonary hypertension became manifest. Re-operations were necessary in 6%. Some patients (4%) developed sinus node disease late after repair, requiring pacemaker implantation. At last follow-up (91 survivors) 92% of the patients were in NYHA class I. Pulmonary hypertension was found in 4%, and aorta insufficiency in 16%. Patients experienced difficulties when applying for insurance.
  
  
  CONCLUSIONS
  Among patients with surgically repaired VSDs, late results were good, although some late sudden deaths occurred in the patients with pulmonary hypertension. Furthermore, some patients developed sinus node disease late after repair, requiring pacemaker implantation. Employability is good, but pregnancy and insurance matters need further attention.
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. j.roos@erasmusmc.nl
authors.forename: J W
authors.initials: JW
authors.lastname: Roos-Hesselink
authors.forename: F J
authors.initials: FJ
authors.lastname: Meijboom
authors.forename: S E C
authors.initials: SE
authors.lastname: Spitaels
authors.forename: R
authors.initials: R
authors.lastname: Van Domburg
authors.forename: E H M
authors.initials: EH
authors.lastname: Van Rijen
authors.forename: E M W J
authors.initials: EM
authors.lastname: Utens
authors.forename: A J J C
authors.initials: AJ
authors.lastname: Bogers
authors.forename: M L
authors.initials: ML
authors.lastname: Simoons
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D004562:Electrocardiography; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000401:mortality* / Q000601:surgery; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000401:mortality; D007223:Infant; D007231:Infant, Newborn; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000601:surgery; D011379:Prognosis; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors