Abstract
Preface. At present the surgical treatment of congenital heart diseases is performed in childhood. At the same time some patients who due to different reasons were not operated on in childhood appeal to cardiac surgery in adulthood. We refer in particular to patients with the ventricular septal defect. Results of surgical treatment of adult patients with ventricular septal defect have not been studied well enough.
Objective.To study complications of natural development and immediate results of surgical correction of ventricular septal defect in adult patients.
Material and methods. 162 patients with ventricular septal defect who are older than 18 years were included in the retrospective cohort study. Within the period from 1995 to 2012 the patients underwent the defect repair. Outcomes. The complications of natural development of the defect such as infective endocarditis and pulmonary hypertension developed in 4 (2.5 %) and in 16 (9.9 %)patients respectively. While the high pulmonary hypertension (3 A hemodynamic group) developed in 5 patients, the medium pulmonary hypertension (2ndhemodynamic group) was diagnosed in 11cases. Different failures of heart rhythm by the moment of surgery were registered in 10 patients (6.5 %). 161 patients underwent surgery successfully. 1 patient died.
Conclusion. The study results has reported that even with the small size of ventricular septal defect (trabecular excluded) and small arteriovenous shunt in adult patients there is a high risk of development of such complications as aortic and tricuspid failure, rupture of aneurysm of the sinus of Valsalva and arrhythmia. Infective endocarditis, though developing not so often, is also a serious complication of the long existing defect. The above data indicate the necessity of surgical treatment of ventricular septal defect in childhood, before development of the above complications.
References
Бокерия Л. А., Беришвили И. И. Хирургическая анатомия сердца. М., 2006.
<br>Данилов Т. Ю. Результаты хирургического лечения ДМЖП с аортальной недостаточностью: дис. … канд. мед. наук. М., 2001.
<br>Chaudhry T. A., Younas M., Baig A. Ventricular septal defect and associated complications // J. Pak. Med. Assoc. 2011. Vol. 61. P. 1001-1004.
<br>Chiu S. N., Wang J. K., Lin M. T. et al. Progression of aortic regurgitation after surgical repair of outlet-type ventricular septal defects //Am. Heart J. 2007. Vol. 153. P. 336-342.
<br>Glen S., Burns J., Bloomfield P. Prevalence and development of additional cardiac abnormalities in 1448 patients with congenital ventricular septal defects // Heart. 2004. Vol. 90. P. 1321-1325.
<br>Mongeon F. P., Burkhart H. M., Ammash N. M. et al. Indications and outcomes of surgical closure of ventricular septal defect in adults // JACC Cardiovasc. Interv. 2010. Vol. 3. P. 290-297.
<br>Rodriguez F. H., Moodie D. S., Parekh D. R. et al. Outcomes of hospitalization in adults in the United States with atrial septal defect, ventricular septal defect, and atrioventricularseptal defect // Am. J. Cardiol. 2011. Vol. 108. P. 290-293.
<br>Russell H. M., Forsberg K., Backer C. L. et al. Outcomes of radial incision of the tricuspid valve for ventricular septal defect closure // Ann. Thorac. Surg. 2011. Vol. 92. P. 685-690.
<br>Soto B., Becker A. E., Moulaert A. J. et al. Classification of ventricular septal defects // Br. Heart J. 1980. Vol. 43. P. 332-343.
<br>Tweddell J. S., Pelech A. N., Frommelt P. C. Ventricular septal defect and aortic valve regurgitation: pathophysiology and indications for surgery // Semin. Thorac. Cardiovasc. Surg. Pediatr. Card. Surg. Annu. 2006. Vol. 9. P. 147-52.
<br>Warnes C. A., Williams R. G., Bashore T. M. et al. ACC/AHA 2008 Guidelines for the management of adults with congenital heart disease // Circulation. 2008. Vol. 118. P. 714-833.
