Surgical Treatment for Congenital Ventricular Septal Defect Combined with Severe Pneumonia in Infants_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HANZhe ,  WANGJian-ming

Department of Cardiovascular Surgery, Children's Hospital in Hebei Province, Shijiazhuang 050030, P. R. China;

Corresponding author：

WANGJian-ming, Email: 18610040424@163.com

Keywords：

Congenital ventricular septal defect; Infant; Severe pneumonia; Emergency operation

DOI：

10.7507/1007-4848.20160250

Video：

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Objective To investigate the clinical effectiveness of early repair in infants with large ventricular septal defect complicated with pneumonia. Methods We retrospectively analyzed the clinical data of 30 infants who underwent emergency operation in our hospital between January 2014 and April 2015. There were 16 males and 14 females at age of 0.9-12.0 (4.6±2.9) months and with weight of 3.0-8.8 (5.6±1.4) kg. They were diagnosed as ventricular septal defect combined with pneumonia as a trial group. There were other 30 patients without pneumonia, 10 males and 20 females, aged of 0.7-19.0 (4.9±4.8) months, weighing 2.6-12 (5.8±2.1) kg, as a control group. All the patients were followed up for 6 months. Results One patient died in the trial group. None died in the control group. There were statistical differences in length of hospital stay (15.73±6.44 d vs. 10.16±2.16 d, P=0.002) and mechanical ventilation time (28.00±15.72 h vs.12.17±9.10 h, P=0.000) between the trial group and the control group. There was no statistical difference in aortic cross-clamping time, cardiopulmonary bypass time, or CICU residence time (P > 0.05). All the patients were followed up for 6 months. Incidence of pneumonia reduced, growth status and exercise tolerance significantly improved. Conclusion Emergency operation for the infants who suffered from ventricular septal defect with severe pneumonia is efficient and effective. Early mechanical ventilation may be beneficial to the procedure.

Citation： HANZhe, WANGJian-ming. Surgical Treatment for Congenital Ventricular Septal Defect Combined with Severe Pneumonia in Infants. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(11): 1066-1069. doi: 10.7507/1007-4848.20160250 Copy

1.	Spicer DE, Hsu HH, Co-Vu J, et al. Ventricular septal defect. Orph-anet J Rare Dis, 2014, 19(9): 144-145.
2.	Vaidyanathan B, Roth SJ, Rao SG, et al. Outcome of ventricular septal defect repair in a developing country. J Pediatr, 2002, 140(6): 736-741.
3.	Beyens T, Biarent D, Bouton JM, et al. Cardiac surgery with extraco-rporeal circulation in 23 infants weighing 2 500 g or less: short and intermediate term outcome. Eur J Cardiothorac Surg, 1998, 14(2): 165-172.
4.	Becerra V, Althabe M, Salgado G. Ventricular septal defect repair in children during first year of life in a public hospital. Arch Argent Pediatr, 2014, 112(6): 548-552.
5.	Ungerleider RM, Bengur AR, Kessenich AL, et al. Risk factors for higher cost in congenital heart operations. Ann Thorac Surg, 1997, 64(1): 44-48.
6.	Li JJ, Liu CF, Yuan Z, et al. Treatment of congenital heart disease complicated by severe bronchopneumonia in infants. Chin J Contemp Pediatr, 2009, 11(8): 405-408.
7.	Li BY, Yang YF, Wu ZS, et al. Early surgical treatment for infants with large atrial septal defects or ventricular septal defects compli-cated by pneumonia:experience of 39 cases. Chin J Contemp Pediatr, 2008, 10(3): 315-318.
8.	祝忠群, 苏肇伉, 史珍英, 等．婴儿大型室间隔缺损并发肺炎和呼吸衰竭的Ⅰ期手术治疗.中华小儿外科杂志, 2005, 26(10): 526-529.
9.	Sadoh WE, Osarogiagbon WO. Underlying congenital heart disease in Nigerian children with pneumonia. Afr Health Sci, 2013, 13(3): 607-612.
10.	An P, Fan Q, Zhang XJ, et al. Change of plasma urotensinⅡlevel in children with pneumonia complicated with congestive heart failure and its clinical significance. J Appl Clin Pediatr, 2009, 24(6): 446-448.
11.	曾嵘, 庄建, 陈寄梅, 等.低出生体重儿及早产儿心脏手术的早期疗效分析.中国胸心血管外科临床杂志, 2012, 19(3): 227-231.
12.	Seo DM, Park JJ, Yun TJ, et al. The outcome of open heart surgery for congenital heart disease in infants with low body weight less than 2500 g. Pediatr Cardiol, 2011, 32(5): 578-584.
13.	Castro-Rodríguez CO, Rodríguez-Hernández L, Estrada-Loza MJ, et al. Prognostic factors associated with postoperative morbidity in children with isolated ventricular septal defect. Rev Med Inst Mex Seguro Soc, 2015, 53(3): 324-335.
14.	Bhatt M, Roth SJ, Kumar RK, et al. Management of infants with large, unrepaired ventricular septal defects and respiratory infection requiring mechanical ventilation. J Thorac Cardiovasc Surg, 2004, 127(5): 1466-1473.
15.	凌庆, 汪涛, 赵萍, 等.新生儿复杂先天性心脏病的外科治疗.中国胸心血管外科临床杂志, 2005, 12(3): 155-157.
16.	Levy JH, Tanaka KA. Intlammatory response to cardiopulmonary bypass. Ann Thorac Surg, 2003, 75(2): 715-720．.
17.	Scully BB, Morales DL, Zafar F. Current expectations for surgical repair of isolated ventricular septal defects. Ann Thorac Surg, 2010, 89(2): 544-549.
18.	Ma QL, Chen ZY, Shi FW. Surgical treatment of large ventricular septal defect complicated with pneumonia in infants. J Appl Clin Pediatr, 2011, 26(1): 62-63, 71.
19.	杨菊先, 王旭, 陈霞, 等.小儿先天性心脏病手术后腹膜透析治疗.中国胸心血管外科临床杂志, 2003, 10(3): 210-212.
20.	Ferrazzi P, Glauber M, Di Domenico A. Assisted circulation for myocardial recovery after repair of congenital heart disease. Eur J Cardiothorac Surg, 1991, 5(8): 419-423.

1. Spicer DE, Hsu HH, Co-Vu J, et al. Ventricular septal defect. Orph-anet J Rare Dis, 2014, 19(9): 144-145.
2. Vaidyanathan B, Roth SJ, Rao SG, et al. Outcome of ventricular septal defect repair in a developing country. J Pediatr, 2002, 140(6): 736-741.
3. Beyens T, Biarent D, Bouton JM, et al. Cardiac surgery with extraco-rporeal circulation in 23 infants weighing 2 500 g or less: short and intermediate term outcome. Eur J Cardiothorac Surg, 1998, 14(2): 165-172.
4. Becerra V, Althabe M, Salgado G. Ventricular septal defect repair in children during first year of life in a public hospital. Arch Argent Pediatr, 2014, 112(6): 548-552.
5. Ungerleider RM, Bengur AR, Kessenich AL, et al. Risk factors for higher cost in congenital heart operations. Ann Thorac Surg, 1997, 64(1): 44-48.
6. Li JJ, Liu CF, Yuan Z, et al. Treatment of congenital heart disease complicated by severe bronchopneumonia in infants. Chin J Contemp Pediatr, 2009, 11(8): 405-408.
7. Li BY, Yang YF, Wu ZS, et al. Early surgical treatment for infants with large atrial septal defects or ventricular septal defects compli-cated by pneumonia:experience of 39 cases. Chin J Contemp Pediatr, 2008, 10(3): 315-318.
8. 祝忠群, 苏肇伉, 史珍英, 等．婴儿大型室间隔缺损并发肺炎和呼吸衰竭的Ⅰ期手术治疗.中华小儿外科杂志, 2005, 26(10): 526-529.
9. Sadoh WE, Osarogiagbon WO. Underlying congenital heart disease in Nigerian children with pneumonia. Afr Health Sci, 2013, 13(3): 607-612.
10. An P, Fan Q, Zhang XJ, et al. Change of plasma urotensinⅡlevel in children with pneumonia complicated with congestive heart failure and its clinical significance. J Appl Clin Pediatr, 2009, 24(6): 446-448.
11. 曾嵘, 庄建, 陈寄梅, 等.低出生体重儿及早产儿心脏手术的早期疗效分析.中国胸心血管外科临床杂志, 2012, 19(3): 227-231.
12. Seo DM, Park JJ, Yun TJ, et al. The outcome of open heart surgery for congenital heart disease in infants with low body weight less than 2500 g. Pediatr Cardiol, 2011, 32(5): 578-584.
13. Castro-Rodríguez CO, Rodríguez-Hernández L, Estrada-Loza MJ, et al. Prognostic factors associated with postoperative morbidity in children with isolated ventricular septal defect. Rev Med Inst Mex Seguro Soc, 2015, 53(3): 324-335.
14. Bhatt M, Roth SJ, Kumar RK, et al. Management of infants with large, unrepaired ventricular septal defects and respiratory infection requiring mechanical ventilation. J Thorac Cardiovasc Surg, 2004, 127(5): 1466-1473.
15. 凌庆, 汪涛, 赵萍, 等.新生儿复杂先天性心脏病的外科治疗.中国胸心血管外科临床杂志, 2005, 12(3): 155-157.
16. Levy JH, Tanaka KA. Intlammatory response to cardiopulmonary bypass. Ann Thorac Surg, 2003, 75(2): 715-720．.
17. Scully BB, Morales DL, Zafar F. Current expectations for surgical repair of isolated ventricular septal defects. Ann Thorac Surg, 2010, 89(2): 544-549.
18. Ma QL, Chen ZY, Shi FW. Surgical treatment of large ventricular septal defect complicated with pneumonia in infants. J Appl Clin Pediatr, 2011, 26(1): 62-63, 71.
19. 杨菊先, 王旭, 陈霞, 等.小儿先天性心脏病手术后腹膜透析治疗.中国胸心血管外科临床杂志, 2003, 10(3): 210-212.
20. Ferrazzi P, Glauber M, Di Domenico A. Assisted circulation for myocardial recovery after repair of congenital heart disease. Eur J Cardiothorac Surg, 1991, 5(8): 419-423.

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Surgical Treatment for Congenital Ventricular Septal Defect Combined with Severe Pneumonia in Infants

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