Author + information
- Received June 27, 1983
- Revision received November 21, 1983
- Accepted November 28, 1983
- Published online May 1, 1984.
- Scott B. Yeager, MD*,1,
- Michael D. Freed, MD, FACC**,1,
- John F. Keane, MD1,
- William I. Norwood, MD, FACC1 and
- Aldo R. Castaneda, MD, FACC1
- ↵**Address for reprints: Michael D. Freed, MD, Department of Cardiology, The Children's Hospital, 300 Longwood Avenue. Boston. Massachusetts 02115.
Between January 1973 and July 1981, 128 patients less than 1 year of age with failure to thrive, congestive heart failure or pulmonary artery hypertension underwent primary repair of a ventricular septal defect. The hospital mortality rate was 7.8% (10 of 128), and the late mortality rate was 2.3% (3 of 128). Mortality was highest among younger infants with preexisting respiratory problems or a hemodynamically significant residual lesion postoperatively. Complications included a large residual shunt in eight (6.2%), transient neurologic problems in five (3.9%) and persistent complete heart block in three (2.3%). Lung biopsy specimens obtained from 49 patients showed pulmonary vascular abnormalities in all. Complete right bundle branch block developed in 74 (64%) and bifascicular block appeared in 11 (9%).
Recatheterization in 70 patients (55%) showed normal pulmonary artery pressures in all but 2 patients with a large residual shunt. Complete closure of the defect had been achieved in 49 (70%), and a hemodynamically insignificant shunt remained in 19 (27%). Patients without significant hemodynamic residua were asymptomatic and tended to accelerate in growth after surgery.
- Received June 27, 1983.
- Revision received November 21, 1983.
- Accepted November 28, 1983.
- American College of Cardiology Foundation