BACKGROUND: This study investigated changes in left ventricular (LV) systolic function after VSD closure and attempts to elucidate the time period of recovery of LV function and factors affecting the same.
METHODS: Echocardiograms were recorded before & after operative repair of VSD over a period of 2 years (January 2007 - November 2008). Systolic - ejection fraction and fractional shortening was used for follow up. Data was analyzed with respect to demographic features, VSD profile, degree of shunt (based on clinical and echo criteria), and associated lesions and Effect of surgery was analyzed with respect to duration and cross clamp time. Post operative echocardiogram was performed at 7th, 30,90 and 180 postoperative day with uniform institutional medication protocol. Statistical analysis was done using SPSS (version 17).
RESULTS: 357 cases (32% of the total operated cases) underwent VSD closure. Ejection fraction, & fractional shortening decreased after VSD repair (p < 0.05) in 101 (28%). The VSDs were perimembranous, doubly committed, muscular and multiple present in 68%, 10%, 12% respectively .72.2% had large, 11% moderate shunt. Ventricular function recovered at90th postoperative day in 71%cases. Flattened septal motion persisted upto 6 months in 66%. Those having persistent LV dysfunction (n=12) had prolonged bypass time (p <0.05), and associated shunt lesions.(p<0.05).
CONCLUSIONS: Ventricular dysfunctions after VSD closure recovers in most patients over 6 months. Additional studies are needed to define changes in after load, contractility as well as diastolic dysfunction and systolic mechanics.