[Ventricular septal defects: anatomic, clinical, therapeutic and prognostic aspects. 44 cases].

OBJECTIVES

The aim of this study is to analyze epidemiologic, anatomic, clinical and prognostic aspects of ventricular septal defect (VSD) in the pediatric population in Morocco.

METHODS

This retrospective descriptive study included 44 consecutive patients admitted to the cardiology B department of Rabat University Hospital Center from January 2000 through March 2003. The inclusion criteria were: VSD, isolated or associated with other left-right shunt defects, diagnosed by transthoracic echocardiography, and hospitalized in the service.

RESULTS

VSD accounted for 10.6% of the congenital cardiac diseases hospitalized in our department. Patients' mean age was 2.25 +/- 2.6 years; the consanguinity rate was 29%. The primary clinical symptoms were dominated by failure to gain weight (84%), exertional dyspnea (82%), and repeated bronchitis (72%). Early complications were infundibular stenosis (4 cases), aortic regurgitation (3 cases), and infectious endocarditis (1 case). Nine children had other abnormalities, including 6 with trisomy 21. Echocardiography showed that membranous defects were by far the most common type (88%). All patients received symptomatic medical treatment. Only 31.7% (n=14) had surgery: 11.3% (n=5) to close the hole (corrective) and 20.4% (n=9) for pulmonary artery (palliative) banding. After two years of follow-up, those with surgical correction were all doing well.

CONCLUSION

Surgically closing the VSD is the best way to avoid irreversible pulmonary arterial hypertension; banding should be only a temporary measure while awaiting corrective surgery.