Management of an Associated Ventricular Septal Defect at the Time of Coarctation Repair

Optimal management of a VSD at the time of coarctation repair is controversial.  The retrospective review of the Pediatric Cardiac Care Consortium 1982-2007 evaluated outcomes for 2,022 patients.    The presence of a VSD increased operative mortality 4-fold to 8.3%.  Patients underwent coarct repair and VSD closure at an older age (87 days) than for coarct repair and PA banding (22 days).  Discharge mortality was about 9% for each group.  Hospital mortality for patients who underwent coarct repair but no surgical VSD management had a discharge mortality of 7.9%.