Abstract
Introduction: Atrial septal defect (ASD) and ventricular septal defect (VSD) are the most prevalent congenital heart defects in children. Optimized perioperative management remains crucial to minimizing operative risk and preventing postoperative complications, underscoring our collective responsibility to improve patient outcomes.
Materials and Methods: This five-year retrospective review at our tertiary cardiac surgery centre (January 2020 – June 2024) reflects our collective effort to analyse clinical data from pediatric patients undergoing surgical correction for isolated septal defects, to inform clinical practice.
Results: A total of 170 paediatric patients underwent surgical correction during the study period. The cohort included 82 patients (48.2%) diagnosed with ASD and 88 patients (51.8%) with VSD. The broad age range of patients enabled a meaningful evaluation of age-related clinical differences and perioperative outcomes.
Conclusion: This review confirms that ASD and VSD are the most common congenital heart diseases requiring surgical intervention in the pediatric population. Sharing our clinical experience aims to support your efforts in timely surgical correction, guided by accurate clinical and echocardiographic assessment, to prevent disease progression and improve long-term outcomes.
References
Baumgartner, H., De Backer, J., Babu-Narayan, S. V., Budts, W., Chessa, M., Diller, G. P., Lung, B., Kluin, J., Lang, I. M., Meijboom, F., Moons, P., Mulder, B. J. M., Oechslin, E., Roos-Hesselink, J. W., Schwerzmann, M., Sondergaard, L., Zeppenfeld, K., & ESC Scientific Document Group (2021). 2020 ESC Guidelines for the management of adult congenital heart disease. European heart journal, 42(6), 563–645. https://doi.org/10.1093/eurheartj/ehaa554
Stout, K. K., Daniels, C. J., Aboulhosn, J. A., Bozkurt, B., Broberg, C. S., Colman, J. M., Crumb, S. R., Dearani, J. A., Fuller, S., Gurvitz, M., Khairy, P., Landzberg, M. J., Saidi, A., Valente, A. M., & Van Hare, G. F. (2019). 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 139(14), e698–e800. https://doi.org/10.1161/CIR.0000000000000603
Penny, D. J., & Vick, G. W., 3rd (2011). Ventricular septal defect. Lancet (London, England), 377(9771), 1103–1112. https://doi.org/10.1016/S0140-6736(10)61339-6
Jone, P. N., Ivy, D. D., Hauck, A., Karamlou, T., Truong, U., Coleman, R. D., Sandoval, J. P., Del Cerro Marín, M. J., Eghtesady, P., Tillman, K., & Krishnan, U. S. (2023). Pulmonary Hypertension in Congenital Heart Disease: A Scientific Statement From the American Heart Association. Circulation. Heart failure, 16(7), e00080. https://doi.org/10.1161/HHF.0000000000000080
Kotowycz, M. A., Therrien, J., Ionescu-Ittu, R., Owens, C. G., Pilote, L., Martucci, G., Tchervenkov, C., & Marelli, A. J. (2013). Long-term outcomes after surgical versus transcatheter closure of atrial septal defects in adults. JACC. Cardiovascular interventions, 6(5), 497–503. https://doi.org/10.1016/j.jcin.2012.12.126
Sondheimer, H. M., & Rahimi-Alangi, K. (2006). Current management of ventricular septal defect. Cardiology in the young, 16 Suppl 3, 131–135. https://doi.org/10.1017/s1047951106001065
Marelli, A. J., Ionescu-Ittu, R., Mackie, A. S., Guo, L., Dendukuri, N., & Kaouache, M. (2014). Lifetime prevalence of congenital heart disease in the general population from 2000 to 2010. Circulation, 130(9), 749–756. https://doi.org/10.1161/CIRCULATIONAHA.113.008396
Berger, J. A., Huh, D. D., Lee, T., Wadia, R. S., Bembea, M. M., & Goswami, D. K. (2021). Perioperative management and considerations in pediatric patients with connective tissue disorders undergoing cardiac surgery. Paediatric anaesthesia, 31(7), 820–826. https://doi.org/10.1111/pan.14196
Arvind, B., & Saxena, A. (2020). Timing of Interventions in Infants and Children with Congenital Heart Defects. Indian journal of pediatrics, 87(4), 289–294. https://doi.org/10.1007/s12098-019-03133-w
Lee JH, Cho S, Kwak JG, et al. Surgical Repair of Ventricular Septal Defect in Neonates: Indications and Outcomes. Congenital Heart Disease, 2024, 19(1): 69. 83. https://doi.org/10.32604/chd.2024.045137
