ArticlePediatric cardiology2026
Survival Benefit and Persistent Hospitalization Burden After Ventricular Septal Defect Closure in Infants with Trisomy 18 Headings: Hospitalization After VSD Closure in Trisomy 18.
Article in Pediatric cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This retrospective study evaluated the impact of ventricular septal defect (VSD) closure on long-term survival and hospitalization status in infants with trisomy 18. Thirty-three infants with trisomy 18 and VSD (2002-2025) were categorized into three groups: staged VSD closure following pulmonary artery banding (PAB) (n = 7), PAB alone (n = 3), or non-surgical management (n = 23). Median follow-up durations (interquartile range) were 124.6 (75.8-153.1), 17.8 (11.4-18.1), and 17.1 (2.7-59.3) months, respectively. Kaplan-Meier analysis demonstrated significantly better survival in the VSD closure group (log-rank p = 0.009). However, these survivors required frequent unexpected hospitalizations for non-cardiac comorbidities. In univariate negative binomial regression, respiratory and digestive complications were significantly associated with higher unexpected admission rates (incidence rate ratio [IRR] = 1.07, 95% confidence interval [CI]: 1.02-1.12; and IRR = 1.24, 95% CI: 1.08-1.41, respectively; p < 0.01). After multivariable adjustment, only digestive complications showed a notable, though non-significant, trend (IRR = 1.15, 95% CI: 0.98-1.36, p = 0.09). Notably, VSD closure was associated with a higher admission rate in univariate analysis (IRR = 1.95, 95% CI: 0.95-4.00, p = 0.07), but this association disappeared after multivariable adjustment. VSD closure was associated with improved survival in infants with trisomy 18, but a substantial hospitalization burden persisted due to non-cardiac comorbidities. These findings highlight the importance of lifelong multidisciplinary care and detailed parental counseling regarding the expected long-term medical burden following VSD closure.
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