LONG-TERM FOLLOW-UP AFTER SURGICAL CLOSURE OF VENTRICULAR SEPTAL-DEFECT IN INFANCY AND CHILDHOOD

Objectives. The purpose of this study was to assess the health-related quality of life of patients who underwent surgical closure of a ventr icular septal defect at a young age between 1968 and 1980. Background. Since the beginning of open heart surgery for cardiac malformations, the surgical techniques have continually improved. As a result, even i nfants have become eligible for surgical repair. Long term follow up d ata are not available on the health related quality of life of nonsele cted patients after surgical repair at a young age; We therefore condu cted a follow-up study of 176 infants and children consecutively opera ted on in one institution between 1968 and 1980. Methods. Patients who were alive and could be traced through the offices of local registrar s received an invitation to participate in the follow-up study, consis ting of an interview, physical examination, echocardiography, exercise testing and standard 12-lead and 24-h electrocardiography. Results. O ne hundred nine patients (78% of those eligible for follow up) partici pated, The mean interval after operation (+/- SD) was 14.5 +/- 2.6 yea rs. Eighty-four percent of the patients assessed their health as good or very good, and 89% had been free of any medical or surgical interve ntion since the operation. At physical examination all patients were i n good health, Their mean exercise capacity was 100 +/- 17% (range 56% to 141%) of predicted values; 84% of the patients had a normal exerci se capacity. Echocardiography raphy demonstrated a small residual vent ricular septal defect in seven patients (6%). There were no signs of p ulmonary hypertension. No patient had symptomatic arrhythmias.Conclusi ons. Long-term results of surgical closure of ventricular septal defec t in infancy and childhood are good. Pulmonary hypertension is absent. Personal health assessment is comparable to that of the normal popula tion, as is exercise capacity, even though many patients have anatomic , hemodynamic or electrophysiologic sequelae.