Koşuyolu Kalp Eğitim ve Araştırma Hastanesi, Kalp Damar Cerrahisi Kliniği, İstanbul

Background: We present postoperative late complications, late follow-up results and surgical intervention tenhniques who underwent ventricular saptal defect repair. Methods: Between 1985 and 2003, 285 patients with a mean age of 12.6±9 years underwent isolated ventricular septal defect repair in our clinic. There were 146 (51.2%) male and 139 (48.8%) female patients. The type of ventricular septal defect were perimebranous in 218 (76.4%), infundibular in 43 (15%), muscular in 13 (4.3%) and inlet in 11 (3.8%) patients. In two cases the defects were multiple. Fiftyfour (18.9%) ventricular septal defects were repaired by primary closure and 231 (81.1%) defects were repaired by patch closure. The pacth was sythetic in 217 (76.1%) patients and patients own pericardium in 14 (4.9%) patients. Results: There was only 1 (0.4%) hospital mortality. There were 3 (1.2%) late deaths with non cardiac events. Twentytwo patients (7.7%) had complete atrioventricular bloc, three of them received a permanent pacemaker. The patients who repaired by primary closure had no residual or recurreant shunts in the late period. In the last six years, all the interventions were made by trans-septal approah from the rigth atrium. Late morbidity of the approaches that were done by right ventriculotomy were statistically significant (p <0.001). Conclusions: The closure of ventricular septal defects with an additional congenital anomalies by surgical intervention has acceptable morbidity and mortality rates.Closing the defect with a primary suture technique in suitable cases and avoiding rigth ventriculotomy could decrease early and late complications.