PRIMARY REPAIR OF ISOLATED VENTRICULAR SEPTAL-DEFECT IN INFANCY GUIDED BY ECHOCARDIOGRAPHY

Between 1989 and 1995, 96 consecutive infants affected by isolated ven tricular septal defect (VSD) were submitted for primary correction at a median age of 4 months. Of the 96, 60 (group I) underwent surgery on the base of a 2-dimensional Doppler echocardiographic (DD echo) test alone. The preoperative DD echo anatomic definition of the type of VSD was confirmed at surgery in all 60 patients without false-positive re sults in terms of additional cardiac anomalies. There were 2 false-neg atives: in 2 patients an associated cardiac anomaly was not detected b y DD echo and required a second surgical procedure after postoperative cardiac catheterization. During the same period 36 infants (group II) underwent surgical closure of isolated VSD on the basis of cardiac ca theterisation and angiocardiography in addition to DD echo. The retros pective comparison between the 2 groups revealed no significant differ ence in terms of sensitivity and specificity of the diagnostic tools, early and late mortality after surgical correction, postoperative hosp ital stay, and need for late cardiac catheterization and surgery. We c onclude that after an accurate selection, most of the infants with unc omplicated VSD can safely undergo primary repair on the basis of DD ec ho alone. (C) 1997 by Excerpta Medica, Inc.