Inclusion Criteria

Ventricular septal defect (VSD)

Inclusion Criteria:
•Ventricular septal defect diagnosis, any
(single, multiple, NOS) with:
•VSD repair, any (primary closure, patch,
device, multiple repair, fenestration, NOS

Allowable Concomitant Diagnoses:

PDA, ASD, Systemic venous anomaly
 Incidence
VSD
100
90
80 N=130
% of Population

70
60
50
40
30 N=40
N=30
20
10
0
VSD Single VSD Multiple VSD NOS
VSD Types
 Mean* Age at Operation
VSD
5
4.5
4
3.5
3
Age
2.5
(Years)
2
1.5
1
0.5
0
VSD Single VSD Multiple VSD NOS
VSD Types

*Add 25th & 75th Percentiles or +/- Standard Deviation

 Gender Distribution
VSD
100

80
% of Population

50 50 50
60

40
50 50 50
20

0
VSD Single VSD Multiple VSD NOS

VSD Types

Male Female
 Incidence
PA debanding at VSD repair
10
Incidence (%) of Debanding

9
8
7
6 N=2
5 N=1
4
3 N=2
2
1
0
Single Multiple NOS
VSD Types
 Features of Repair:
Mean* CPB & Cx times
7
6
5

Time 4
(Hours) 3 CPB Time
Cx Time
2
1
0
Single Multiple NOS
VSD Types

*Add 25th or 75th Percentiles or +/– Standard Deviation

 Features of Repair:
Incidence DHCA
100
90
80
70
60 N=20 N=35
N=15 N=5 N=5 Single
% 50 Multiple
N=49
40 NOS
30 N=14
N=5
20
10 N=0
0
Total Population </= 6 months > 6 months
 Features of Repair:
VSD closure techniques
100 N=180
90
80
70
60
% of
50
Population
40
30
20
N=12
10 N=1 N=2 N=1 N=4
0
VSD 1º VSD Patch VSD Device VSD Multiple VSD VSD Repair
Repair Repair Fenestration NOS
 Mortality
VSD
100

80
% Mortality

60

40

20 N=6 N=4 N=2

N=4 N=3 N=1 N=2 N=1 N=1

0
VSD Single VSD Multiple VSD NOS
VSD Types

Total Population </= 6 months > 6 months

Mean* Postoperative Length of
Stay - VSD†
20
Length of Stay (Days)

15

10 N=36 N=27
N=66 N=9
N=124 N=28 N=9
N=58 N=19
5

0
VSD Single VSD Multiple VSD NOS
VSD Types

Total Population < 6 months > 6 months

*Add 25th & 75th Percentiles or +/– Standard Deviation

†
Excludes postoperative mortality
 Complications
VSD Single VSD Multiple VSD NOS
All Patients # Patients % Pop # Patients % Pop # Patients % Pop
Operative
Reoperation during this
admission other than for
bleeding
Bleeding requiring
reoperation
Sternum left open
Postoperative mechanical
circulatory support

Cardiac
Cardiac arrest
Low CO
Postoperative acidosis
Postoperative arrhythmia
Postoperative AV block
requiring temporary pacer
Postoperative AV block
requiring permanent pacer
Pericardial effusion requiring
drainage
Postoperative pulmonary
hypertensive crisis
Systemic vein obstruction
Pulmonary vein obstruction
Infection
Complications
Mediastinitis
Wound dehiscence
Wound infection
Postoperative septicemia
Postoperative endocarditis
Respiratory
Postoperative respiratory
insufficiency
Postoperative tracheostomy
Pneumonia
Pneumothorax
Pleural effusion requiring
drainage
Chylothorax
Renal
Acute renal failure requiring
temp dialysis
Acute renal failure requiring
perm dialysis
Neurologic
Postop new onset seizures
Postop neurological deficit
persisting at discharge
Other
Phrenic nerve
injury/paralyzed diaphragm
Recurrent laryngeal nerve
injury/paralyzed vocal cord
Other postoperative
complication
 Complications
VSD Single VSD Multiple VSD NOS
Patients  6 months # Patients % Pop # Patients % Pop # Patients % Pop
Operative
Reoperation during this
admission other than for
bleeding
Bleeding requiring
reoperation
Sternum left open
Postoperative mechanical
circulatory support

Cardiac
Cardiac arrest
Low CO
Postoperative acidosis
Postoperative arrhythmia
Postoperative AV block
requiring temporary pacer
Postoperative AV block
requiring permanent pacer
Pericardial effusion requiring
drainage
Postoperative pulmonary
hypertensive crisis
Systemic vein obstruction
Pulmonary vein obstruction
 Complications
Infection
Mediastinitis
Wound dehiscence
Wound infection
Postoperative septicemia
Postoperative endocarditis
Respiratory
Postoperative respiratory
insufficiency
Postoperative tracheostomy
Pneumonia
Pneumothorax
Pleural effusion requiring
drainage
Chylothorax
Renal
Acute renal failure requiring
temp dialysis
Acute renal failure requiring
perm dialysis
Neurologic
Postop new onset seizures
Postop neurological deficit
persisting at discharge
Other
Phrenic nerve
injury/paralyzed diaphragm
Recurrent laryngeal nerve
injury/paralyzed vocal cord
Other postoperative
complication
Risk Variables for Mortality
Risk Variable % Mortality
Gender Male
Female
Age  6 months
> 6 months
Weight  2.5 kilograms
> 2.5 kilograms
Down syndrome Down syndrome
No Down syndrome
Ventilation Preop mechanical ventilatory support
vs No mechanical ventilatory support
Endocarditis Preop endocarditis
vs No preop endocarditis
Prior CT Presence of prior CT operation
Operation vs No prior CT operation
Prior PA Band Presence of PA debanding at VSD closure
vs No debanding
Risk Variables for Mortality
Other Asplenia
Polysplenia
Turner syndrome
DiGeorge syndrome
Williams-Beuren syndrome
Alagille syndrome (intrahepatic biliary duct
agenesis)
22q11 deletion
Other chromosomal/syndromic abnormality
Rubella
Marfan syndrome
Preoperative mechanical circulatory support
(IABP, VAD, ECMO, or CPS)
Preoperative complete AV block
Preoperative arrhythmia
Preoperative shock
Preoperative acidosis
Preoperative pulmonary hypertension crises
(PA pressure > systemic pressure)
Preoperative tracheostomy
Preoperative renal failure (creatinine > 2)
Preoperative renal failure requiring dialysis
Preoperative bleeding disorder
Preoperative septicemia
Preoperative neurological deficit
Preoperative seizures
Other preoperative noncardiac abnormality
Other preoperative risk factor