A Case of Pericardial Tamponade Induced by Protamine Neutralization and Heparin after Ventricular Septal Defect Surgery

A four year old girl was diagnosed as a case of mid muscular Ventricular Septal Defect (VSD) since early infancy. She had history of failure to thrive (FTT) and recurrent chest infection or pneumonia. As her pulmonary artery pressure was almost normal she was planned for device closure on elective basis once device and technology would be available in cardiac centre of combined Military Hospital (CMH) Dhaka. Finally it was done on 21st August 2005 and patient was discharged after 72 hours observation period. Echocardiography on next morning showed complete occlusion of defect with no residual shunt. (J Bangladesh Coll Phys Surg 2007; 25 : 161-163)

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Echocardiographic Evaluation of Cardiac Remodeling After Surgical Closure of Ventricular Septal Defect in Different Age Group

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v2i2.34097 ◽

2017 ◽

Vol 2 (2) ◽

pp. 69-74

Author(s):

Mohammad Aminullah ◽

Fahmida Akter Rima ◽

Asraful Hoque ◽

Mokhlesur Rahman Sazal ◽

Prodip Biswas ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Ejection Fraction ◽

Cardiac Remodeling ◽

Septal Defect ◽

Left Ventricular ◽

Age Group ◽

Surgical Closure ◽

Group A ◽

Group B ◽

Fractional Shortening

Background: Cardiac remodeling is important issue after surgical closure of ventricular septal defect.Objective: The purpose of the present study was to evaluate cardiac remodeling by echocardiography by measuring the ejection fraction, fractional shortening, left ventricular internal diameter during diastole (LVIDd) and left ventricular internal diameter during systole (LVIDs) after surgical closure of ventricular septal defect in different age group. Methodology: This prospective cohort studies was conducted in the Department of Cardiac Surgery at National Institute of Cardiovascular Disease (NICVD), Dhaka. Patient with surgical closure of VSD were enrolled into this study purposively and were divided into 3 groups according to the age. In group A (n=10), patients were within the age group of 2.0 to 6.0 years; age of group B (n=8) patients were 6.1-18.0 years and the group C (n=6) aged range was 18.1-42.0 years. Echocardiographic variables such as ejection fraction, fractional shortening, LVIDd, LVIDs were taken preoperatively and at 1st and 3rd month of postoperative values. Result: A total number of 24 patients was recruited for this study. The mean ages of all groups were 12.60±12.09. After 1 month ejection fraction were decreased by 5.97%, 6.71% and 5.66% in group A, group B and group C respectively. After 3 months ejection fraction were increased by 6.13%, 5.13% and 5.14% in group A, group B and group C respectively. After 1 month fractional shortening were decreased by 13.55%, 9.30% and 9.09% in group A, group B and group C respectively. After 3 months fractional shortening were increased by 7.23%, 7.35% and 4.55% in group A, group B and group C respectively. After 1 month LVIDd were increased by 1.97%, 1.91% and 1.32% in group A, group B and group C respectively. After 3 months LVIDd were decreased by 10.84%, 9.89% and 7.34% in group A, group B and group C respectively. After 1 month LVIDs were increased by 2.19%, 2.86% and 1.98% in group A, group B and group C respectively. After 3 months LVIDs were decreased by 11.68%, 10.97% and 8.87% in group A, group B and group C respectively.Conclusion: Cardiac remodeling occurred after surgical closure of ventricular septal defect and remodeling were more significant in younger age group. Journal of National Institute of Neurosciences Bangladesh, 2016;2(2):69-74

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