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VENTRICULAR SEPTAL DEFECTS: 2. NATURAL HISTORY OF AN AUSTRALIAN PæDIATRIC SAMPLE 1
Author(s) -
Menahem Samuel
Publication year - 1971
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1971.tb92814.x
Subject(s) - medicine , shunt (medical) , natural history , cardiology , pulmonary artery , presentation (obstetrics) , surgery , pediatrics , heart failure
A six‐year follow‐up of a year's intake of 94 new patients with ventricular septal defects was undertaken. They were initially divided into five groups on the basis of their hæmodynamic disturbance at presentation. The benign course of subjects with small defects was confirmed. Nine such subjects, including one with a larger defect, had evidence of spontaneous closure occurring generally in infancy and early childhood. A further 17 showed signs of decreasing left‐to‐right shunt associated with an absolute or relative decrease in the size of their defects. in contrast, patients with large defects had a substantial morbidity and formidable mortality. Seven such infants showed spontaneous clinical improvement, which in one subject was due to increasing pulmonary vascular resistance. Many infants with large defects required intensive medical therapy, and seven were submitted to pulmonary artery banding to control the large left‐to‐right shunt and consequent cardiac failure. Only seven subjects to date have undergone corrective surgery as they reached an age when bypass techniques might be safely applied. Discussion is centred around these findings in the light of over‐seas work.