Evaluation of Post-Operative Outcomes in Children Undergoing Ventricular Septal Defect Repair

Abstract

Background: Ventricular septal defect (VSD) is the most common congenital heart anomaly, and although surgical repair has excellent survival, postoperative morbidity varies widely. Identifying perioperative determinants of recovery may improve risk stratification and guide targeted postoperative care. Objective: To evaluate the association between preoperative and intraoperative factors and early postoperative outcomes among children undergoing surgical VSD repair. Methods: A cross-sectional observational study was conducted among 40 pediatric patients undergoing VSD repair at a tertiary cardiac center. Consecutive sampling, standardized data extraction, and predefined operational definitions were used. Variables included demographics, preoperative clinical status, cardiopulmonary bypass and cross-clamp durations, and postoperative outcomes such as ventilation time, ICU stay, arrhythmias, low cardiac output syndrome, and residual defects. Statistical analyses incorporated multivariable regression with adjustment for confounders. Results: Younger age, preoperative pulmonary hypertension, longer bypass duration (mean 86.4 vs. 73.3 min), and extended cross-clamp time (51.2 vs. 43.1 min) were associated with prolonged ICU stay (>4 days). Postoperative arrhythmias were significantly higher in prolonged-stay patients (35.7% vs. 3.8%). Overall postoperative morbidity included low cardiac output syndrome in 12.5%, new residual VSD in 7.5%, and no mortality. Conclusion: Preoperative vulnerability and intraoperative burden strongly influence early postoperative trajectories after VSD repair, underscoring the need for risk-adapted perioperative management to optimize recovery.