Seventeen patients had a history of congestive heart failure in infancy out of a total of 125 cases of ventricular septal defect reviewed. The initial episode of cardiac decompensation occurred in the first 6 months of life. Ten of the patients had evidence of unremitting failure and died in the first year of life, while seven survived infancy. Exacerbations of decompensation after infancy were rare; patients who survived the first year of life did not succumb to complications of the defect in childhood.