Possibilities of predicting early postoperative complications after surgical correction in infants of the first year of life with ventricular septal defect

Abstract

Objective. To study the echocardiographic (Echo-CG) indicators in infants of the first year of life with ventricular septal defect (VSD) in the early postoperative period after surgical correction of the defect.

Materials and methods. Examination of 205 infants with VSD was carried out. Complex examination before the surgery, 6, 24 hours and the day 10^th after the surgery was fulfilled.

Results. In the early postoperative period, myocardial dysfunction (MD) was detected in 30.2 % of cases (n = 62). The patients were longer subjected to artificial lung ventilation (p = 0.04), had a longer period of staying in the intensive care unit (p = 0.002) and hospital (p = 0.004). The data, predicting the postoperative MD were revealed including VSD area index (OR 2.7; р = 0.00001), longitudinal deformation of the left ventricle (S_LV; OR 2.69; р = 0.00001), longitudinal deformation of the free wall of the right ventricle (S_RV; OR 1.04; р = 0.0001) and the average estimated pressure in the lung artery (OR 1.6; р = 0.0001).

Conclusions. 1. After the surgery, MD was detected in 30.2 % of cases. 2. S_LV and S_RV in infants with MD demonstrate the aggravation of ventricular contractility earlier than traditional indicators of the systolic function. 3. Preoperative S_LV > «–» 12 %, S_RV > «–» 6 %, VSD area index > 100,5 mm²/m², average estimated pressure in the lung artery > 38 mm Hg are independent predictors of complications accompanied by MD during the first day after the VSD closure. 4. Complications, connected with longer ALV, are associated with duration of staying in the intensive care unit and hospital.

Keywords

ventricular septal defect / surgical correction / myocardial dysfunction / postoperative complications / prognostic ECG-criteria

References

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