title: Results for surgical closure of isolated ventricular septal defects in patients under one year of age.
abstract: BACKGROUND
  This study evaluated the outcomes of patients undergoing surgical repair of isolated ventricular septal defect (VSD) in the first year of life with particular attention to age and severity of pulmonary hypertension (PH).
  
  
  METHODS
  Between July 1, 2002 and May 31, 2012, 282 patients aged less than one year underwent isolated VSD closure at a median age of five months (range, 21 days to 1 year) and a median weight of 5.3 kg (range, 2.9 to 12.5 kg). Patients were divided into three groups according to the age at surgery (0-3, 3-6, and 6-12 months), and groups were compared in regard to severity of PH associated with morbidity and mortality.
  
  
  RESULTS
  Four (1.4%) early and four (1.4%) late deaths occurred postoperatively. All mortalities were patients with severe PH, aged between 3 and 12 months. Although hemodynamic studies revealed a higher incidence of persistent postoperative PH in patients above three months of age, there was no statistically significant difference in morbidity associated with prolonged mechanical ventilation, and long intensive care unit and hospital stays between age-related groups.
  
  
  CONCLUSIONS
  In this study, the incidence of mortality was higher in patients over three months of age undergoing repair of isolated VSD; the data suggest that the mortality may be decreased in patients with severe PH who were operated on earlier in life. We conclude that in infants with severe PH, early surgical repair (less than three months) of isolated VSDs is strongly advised to achieve more favorable results.
authors.affiliation: Department of Pediatric Cardiac Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Numan Ali
authors.initials: NA
authors.lastname: Aydemir
authors.forename: Bugra
authors.initials: B
authors.lastname: Harmandar
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Karaci
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sasmazel
authors.forename: Ahmet
authors.initials: A
authors.lastname: Bolukcu
authors.forename: Turkay
authors.initials: T
authors.lastname: Saritas
authors.forename: Ilker Kemal
authors.initials: IK
authors.lastname: Yucel
authors.forename: Filiz Izgi
authors.initials: FI
authors.lastname: Coskun
authors.forename: Mehmet Salih
authors.initials: MS
authors.lastname: Bilal
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yekeler
mesh_terms: D000367:Age Factors; D005260:Female; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000401:mortality; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019990:Perioperative Care; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013536:Suture Techniques; D016896:Treatment Outcome