Surgical closure of a ventricular septal defect in early childhood leads to altered pulmonary function in adulthood: A long-term follow-up. (1st January 2019)

• Record Type: Journal Article
• Authors: Rex, Christian E.; Eckerström, Filip; Heiberg, Johan; Maagaard, Marie; Rubak, Sune; Redington, Andrew; Hjortdal, Vibeke E.
• Is Part Of: International journal of cardiology. Volume 274(2019)
• Page Start: 100
• Page End: 105
• Publication Date: 2019-01-01
• Subjects: Congenital heart disease -- Exercise capacity -- Long-term follow-up -- Pulmonary function -- Ventricular septal defect; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2018.06.109
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: The long-term outlook after surgical closure of ventricular septal defect (VSD) has traditionally been considered benign. However, there is an increasing awareness of not only late cardiac dysfunction, but also pulmonary abnormalities. The primary aim of this study was to describe pulmonary function in adults with a surgically repaired VSD, and secondarily to determine the effects of salbutamol on the potential abnormalities. Methods: All patients (operated for a VSD in early childhood) and controls (age- and gender-matched) underwent static and dynamic spirometry, impulse oscillometry, multiple breath washout, diffusion capacity for carbon monoxide, and cardiopulmonary exercise testing. In a double-blinded, cross-over study, participants were randomized to inhalation of either 900 μg of salbutamol or placebo. The primary outcome was forced expiratory volume in 1 s. Results: In total, 30 participants with a surgically closed VSD and 30 healthy controls were included. The VSD participants had a lower forced expiratory volume in 1 s (99 ± 13% vs. 111 ± 13%), p < 0.001, impaired forced vital capacity, (106 ± 12% vs. 118 ± 13%), p < 0.001, and lower peak expiratory flow, (95 ± 18% vs. 118 ± 19%), p < 0.001, than the control group. Also, the VSD group had a lower alveolar volume than the control group, (92 ± 10% vs. 101 ± 11%), p < 0.001, but there were no differences in the remaining pulmonary function parameters. Salbutamol reduced airway resistances in both groups, but exercise performance was not improved by salbutamol, however. Conclusions: Adults who have undergone surgical closure of a VSD in early childhood have reduced pulmonary function compared with controls, which is unaffected by inhalation of salbutamol. Highlights: There is an increasing awareness of alterations in pulmonary function in patients operated for a ventricular septal defect This study showed that adults who have undergone surgical closure in early childhood have reduced pulmonary function Also, it showed that the impairments are unaffected by inhalation of salbutamol