Surgical Repair of Ventricular Septal Defects at Soavinandriana Hospital: First Case Series

Introduction: Surgical closure of ventricular septal defects (VSDs) has been feasible in Madagascar since 2024. This study aimed to report the results of a series of VSD surgeries performed at Soavinandriana Hospital. Materials and methods: This retrospective study reports on the first series of nine surgical repairs of ventricular septal defects (VSD) performed at Soavinandriana Hospital in Madagascar between 2024 and 2025. The authors analyze patient demographics, clinical presentation, echocardiography results, surgical techniques involving cardiopulmonary bypass time, and immediate postoperative outcomes. Results: Nine children who underwent surgical repair of VSD are reported in this study, including six boys (66%) and three girls (33%). The average age was 11.89 years. The mean weight was 28.22 kg. The main symptoms were a cardiac murmur (88%), recurrent lung infections (66%), and failure to thrive (66%). Echocardiography revealed seven perimembranous VSDs (77%), two infundibular VSDs (22%), and 8 VSD type IIa (88%). The VSDs were large in 88% of cases, with a mean diameter of 12.11 mm. One patient had a VSD associated with pulmonary hypertension (11%). All VSD repairs were performed using conventional surgery and cardiopulmonary bypass (CPB). The VSDs were most commonly closed using a pericardial heterologous patch (88%). The mean CPB time was 111.22 minutes. The mean aortic cross-clamping time was 58.89 minutes. The postoperative success rate was 100%. Conclusion: The study concludes that surgical closure of large VSDs is feasible in this setting, reporting a 100% success rate in the initial cohort.