Utility of Follow-Up Surveillance Echocardiograms in Uncomplicated Surgical Closures of Perimembranous Ventricular Septal Defects: A Preliminary Analysis

Background: Ventricular septal defects (VSD) are the most common form of congenital heart disease (CHD). Current guidelines recommend surveillance transthoracic echocardiograms (TTE) following surgical closure of perimembranous VSDs (pVSD); however, duration of screening is not explicitly stated. The goal of this study is to determine the utility of follow-up TTEs after uncomplicated pVSD surgical closure. Methods: Single-site retrospective analysis was conducted on patients who underwent pVSD surgical closure. Patients were excluded if diagnosed with other CHD, had complications 1 year post-repair, or lacked data 1 year post-repair. Serial TTEs were reviewed. A Kaplan–Meier curve was used to illustrate the 5-year complication-free survival. Results: A total of 117 patients met inclusion criteria. A 97% 5-year complication-free survival was observed. Four patients had complications >1 year post-repair: one non-obstructive subaortic ridge, one pulmonary vein stenosis, one pinhole residual pVSD, and one ventricular ectopy with ventricular dysfunction. Of the 113 complication-free patients, 197 TTEs were performed with no change in clinical management. Conclusions: Beyond 1 year post-repair, the occurrence of new complications following uncomplicated pVSD surgical closure is rare. Unless clinical concerns arise, the utility of routine TTEs > 1 year post-repair in this uncomplicated post-surgical cohort should be reassessed. Larger multicenter studies are needed to determine the utility of routine TTEs.