Clinical Presentation of Preterm Infants with Ventricular Septal Defect

MITSUHIKO RIKO,^1,2 KATSUAKI TOYOSHIMA,¹ TOMOYUKI SHIMOKAZE,¹ TAKESHI KUMAGAI² and HIROYUKI SUZUKI²

¹Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
²Department of Pediatrics, Wakayama Medical University, Wakayama, Wakayama, Japan

Ventricular septal defects (VSDs) are the most common congenital heart diseases; however, case reports of preterm infants with VSD are limited. The aim of this study is to share our experience with preterm infants with VSD and to record their short-term outcomes. Between January 2000 and December 2017, 32 preterm infants with VSD were admitted to our neonatal intensive care unit at gestational age < 32 weeks. Of these, 9 were excluded by exclusion criteria. The size and location of the VSD, details of treatment, and neonatal prognosis were retrospectively reviewed from the medical records. Among the 23 preterm infants, the median gestational age was 29.4 weeks (25.0-31.3 weeks) and the median birthweight was 924 g (524-1,526 g). There were 9 infants with VSD < 2 mm and 14 infants with VSD 2 mm. For the 9 infants with VSD < 2 mm, no medical or surgical treatments for VSDs were undertaken. Of the 14 infants with VSD 2 mm, 8 (57.1%) underwent medical and surgical treatment. Surgical treatment was performed more frequently in infants with VSD 2 mm than in those with VSD < 2 mm (P = 0.007). In preterm infants, the presence of VSD 2 mm increases the risk of surgical interventions and significant patent ductus arteriosus. It is important to encourage treatment for preterm infants with VSD 2 mm, including surgical interventions, in cooperation with pediatric cardiologists.

Keywords —— patent ductus arteriosus; preterm infants; spontaneous closure; surgical intervention; ventricular septal defect

===============================

Tohoku J. Exp. Med 2020 252, 281-286.

Correspondence: Mitsuhiko Riko, M.D., Department of Pediatrics, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama 641-8509, Japan.

e-mail: mricoh@wakayama-med.ac.jp