Ventricular Septal Defect: Natural History in Infancy and Childhood

Abstract

One hundred and fifty-five consecutive cases of isolated ventricular septal defect, proved at cardiac cathe-terization, have been observed for an average of 7.2 years. Eighteen patient were operated upon with complete closure of the defect. At follow-up 10 patients (7 per cent) were found to have died in the course of the disease. Spontaneous closure of the defect was observed in 12 cases (8 per cent). Almost all of them had small defects at the initial haemodynamic study. In about a third of the total number of patients clinical and haemodynamic data suggested a decrease in the functional size of the defect. The period of the most rapid improvement was usually seen in the first two years of life. Cardiac failure was seen in 38 patients (25 per cent) during the observation period. The symtoms were most severe during the first year of life, less severe during the second, and then gradually disappeared during the third and fourth years. Progressive pulmonary vascular disease was observed in 15 cases (10 per cent). In cases followed from birth, there was often seen a temporary decrease of the pulmonary vascular resistance during the first and sometimes even during the second year, which then was followed by a progressive increase, that, however, became less conspicious after puberty.