Surgical closure of ventricular septal defect: Contemporary results and risk factors for electrophysiological changes.

Background: The surgical closure of a ventricular septal defect (VSD) is a commonly performed procedure. PostoperativeECG changes are common findings that need a proper assessment to provide valuable insights into the outcomes of thepatients. In this study, we investigate the potential risk factors associated with electrophysiological changes followingsurgical closure of VSD.Patients and Methods: A prospective, nonrandomized study was conducted from October 2020 to December 2022 onpatients scheduled for VSD closure. Patients with prior abnormal congenital electrophysiological disturbances, internalpacemaker, Ebstein’s anomaly, associated subaortic membrane or hypertrophic obstructive cardiomyopathy, iatrogenicVSD, and need aortic root dilatation with VSD closure were excluded. 12-lead ECG was reported on ICU admissionand daily after that till discharge. Various demographic and perioperative data were recorded, and their correlation to thepresence of electrophysiological changes and outcomes were analyzed.Results: Two hundred patients who underwent surgical VSD closure were included. Arrhythmias occurred in 41 (20.5%)patients. The encountered arrhythmias were sinus bradycardia with junctional escape in 24 patients, junctional ectopictachycardia in 10 patients, supraventricular tachycardia in two patients, premature complex in two patients, second-degreeheart block in four patients, and third-degree block in two patients. Mother’s hypertension, preoperative mechanicalventilation, associated cardiac anomalies, Down syndrome, size of VSD, type of VSD, total bypass time, aortic crossclamptime, concomitant procedures, intraoperative pacing, and residual VSD were identified in univariate analysis asrisk factors for occurrence of arrhythmias.Conclusion: Surgical VSD closure is a safe procedure with low mortality and morbidity rates. Younger age and lowerbody weight are risk factors for prolonged hospitalization, ICU stay, and mechanical ventilation. Longer cross-clamp andcardiopulmonary bypass times were significant predictors of postoperative ECG changes and associated complicationswith prolonged ICU and hospital stay.