Work

Long-term outcome after surgical ventricular septal defect closure: Longitudinal follow-up into the fifth decade

Year: 2025

Type: article

Abstract: Objectives To evaluate survival, clinical outcome and quality of life (QoL) of patients up to 49 years after surgical ventricular septal defect (VSD) closure. Methods Single-center, longitudinal cohort study evaluating consecutive patients with surgical VSD closure between 1968 and 1980 with extensive cardiac and QoL evaluation every decade. Results Of the original cohort of 174 patients, 39 died (22%), 8 were lost to follow-up and 38 had not participated previously. Survival rate at 49 years follow-up was 77% and 86% when excluding early postoperative mortality. Of the 89 eligible survivors, 76 (85%) were evaluated (59% male, median age 49 [44-54] years) with a median follow-up of 44 (range 40-49) years after surgery. Event-free survival at 49 years was 50%, with symptomatic arrhythmias (10%), pacemaker implantation (8%) and VSD-related interventions (3%) being common complications. At last follow-up, 58% had left atrial dilation, 25% had aortic regurgitation and 5 patients (7%) had a residual VSD. Early postoperative arrhythmias predicted mortality. Both left ventricular (LV) and right ventricular ejection fraction remained stable, with only 1% having an LV ejection fraction below 45% at last follow-up. Exercise capacity and VO 2 max were mildly reduced in 33% and 49% of the patients while self-perceived QoL was stable and comparable with the general Dutch population. Conclusion Half of the patients with surgical VSD closure had an event-free survival at 49 years. Pacemaker implantation was often needed. Early postoperative arrhythmias predicted mortality. QoL was good and remained stable over time.

Source: International Journal of Cardiology Congenital Heart Disease

DOI: 10.1016/j.ijcchd.2025.100624