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Ventricular Septal Defect (VSD) Among Children Attending Three Health Institutions: Clinical Correlates and Patients’ Characteristics

Josephat M Chinawa*, Chika O. Duru, Awoere Tamunosiki Chinawa, Chukwu Bartholomew

Background: Ventricular Septal Defect (VSD) is the commonest acyanotic congenital heart disease which presents with some clinical and post-operative characteristics.
Objectives: This study is aimed at determining clinical and post-operative characteristics of children with VSD.

Methods: An observational study, done in three institutions over a five-year period. Seven hundred and fifty-eight (758) echocardiography reports on children with cardiac defects were ascertained and a total of 151 children had VSD was extracted.

Results: An observational study, done in three institutions over a five-year period. Seven hundred and fifty-eight (758) echocardiography reports on children with cardiac defects were ascertained and a total of 151 children with VSD were extracted, with a mean age of 3.3 ± 4.4 years.The patients’ characteristics evaluated in this study include clinical profile, surgical outcome and nutritional status of children with VSD. Fast breathingwas the commonest clinical findings in children with VSD70 (127); 55.1%, followed by cough 11 (68; 16.2%) and poor weight gain 55 (125); 44%.Thirty point nine (30.9%) were both wasted and stunted. 6.9% of the children were overweight (BMI+2SD) and 2.0% obese BMI+3SD). Aortic regurgitation was noted in (5/150) 3.3% of children with VSD, seen commonly in Peri-membranous VSD. Prevalence of pulmonary hypertension in this study was 47 (31.3%). Complications noted post-operation are aortic regurgitation 3.3%, and residual VSD. Seventeen point nine (17.9%) (27/151) of the patients had surgery for surgical closure of VSD. There were a total of 19 deaths of which 47.4% was before surgery and 52.6% among the females.There were a total of 19 deaths of which 47.4% were before surgery and 52.6% among the females. Majority of the deaths was in the infants (47.4%), the preschool and school age contribute 21.0% each and the adolescents, 10.5%. Among the 27 children that had surgery, 37.0% died post-surgery while 7.4% were lost to follow up. The remaining 56.0% are alive and being followed up with others who are yet to have surgery. Cause of death was documented in 13 of the 14 deaths, (10 post-surgery and 4 before surgery). Other causes of death included rheumatic heart disease (23.1%), heart failure (15.4%), and fall at home (15.4%), infective endocarditis (7.6%) and post-surgery achalasia (7.7%).

Conclusion: The frequent symptom of VSD is fast breathing and Peri-membranous type is the commonest. Aortic regurgitation is the commonest post-surgical complication associated with VSD closure. The children present with various degrees of malnutrition. There was ahigh mortality noted before surgery.