Early Repair of Ventricular Septal Defect in Infants and Young Children

In infants and young children with ventricular septal defects (VSD) direct primary closure of the VSD can give very satisfactory results with a mortality that compares well with that of pulmonary artery banding. Twenty-four infants ranging in age from 5 to 29 months and in weight from 4.2 kg to 11.5 kg (9 to 25 lb) underwent intracardiac repair of their defect. Six had an associated atrial septal defect and two a patent ductus arteriosus. Of the four hospital deaths (none younger than 12 months of age), two patients had multiple muscular defects, and all four had a pulmonary artery pressure equal to the systemic with increased pulmonary vascular resistance (over 6 units). The surviving 20 patients showed improvement in their weight, clinical cardiopulmonary status, and electrocardiographic patterns. A curative repair should be considered in the infant with VSD, especially in the presence of associated atrial septal defect.