[Results of the surgical closure of ventricular septal defects of various ages: report of 30 cases].
OBJECTIVE
To appreciate short and midterm results of patients after surgical closure of the ventricular septal defect.


METHODS
The study is retrospective and took place in the department of cardiovascular surgery "B", Ibn-Sina hospital, Rabat, Morocco. Between 1995 and 2005, 30 patients underwent a surgical closure of ventricular septal defect. Eighteen patients (60%) were males and twelve (40%) were females with a mean age of 10 years (18 months-36 years). Seven patients (23%) were older than 16 years. All of ventricular septal defects were type 2, unique and most of them perimembranous (70%). Four patients (13%), were older than 16 years, had a significant aortic insufficiency that has dictated the aortotomy for ventricular septal defect repair. The surgical approach through the right atriotomy was sufficient for complete repair in 22 patients (73%). Closure of the defect has been done using a pericardial autologous patch in 28 patients (93%).


RESULTS
No operative mortality was observed. The mean follow-up was five years. Eight patients (26%) had a residual ventricular septal defect that progressed to spontaneous closure. Two patients (6%) had a residual pulmonary hypertension and two others a moderate aortic regurgitation. The four patients were older than 16 years. Echocardiography showed a significant reduction in left ventricular dimension and systolic pulmonary artery pressure. At last follow-up, 87% of the patients were in NYHA class 1.


CONCLUSIONS
This study demonstrates that surgical closure of ventricular septal defect ensures a good outcome in short and midterm. Nevertheless, the risk of delayed complications justifies long-term and regular follow-up.
Tribak
M
M
Service de chirurgie cardiovasculaire B, hôpital Ibn-Sina, Rabat, Maroc. tribakmed@yahoo.fr <tribakmed@yahoo.fr>
Marmade
L
L
El Kouache
M
M
El Moktadir
K
K
Abdallah
H
H
Maghraoui
S A
SA
Baghdadi
K
K
Laaroussi
M
M
Moughil
S
S
Bensouda
A
A
Benomar
Mh
M
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D008297:Male; D010496:Pericardium / Q000637:transplantation; D011651:Pulmonary Artery; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography