This paper is only available as a PDF. To read, Please Download here.
This study was designed to determine the clinical status, cause of death, and effects of pulmonary vascular disease and conduction abnormalities 30 to 35 years after surgery in 296 consecutive surviving patients of closure of ventricular septal defect. Of the 296 patients, current status was determined by contact with patient and physician in 290 cases, with 6 (2%) lost to follow-up (7,912 patient years are included). Cardiac catheterization after surgery in 168 patients showed complete closure of the defect in 80%. Death occurred in 59 patients (20%), with higher mortality rates in those operated on after the age of 5 years, those with pulmonary vascular resistance >7 units (51%), and those with complete heart block (78%). Of 37 patients with transient heart block after surgery, 8 (22%) have died (3 pulmonary vascular disease, 2 sudden death, 2 unknown causes and 1 complete heart block). Twenty other patients had a dysrrhythmia after surgery, and none of these died. Nine episodes of endocarditis occurred ( patient years). Nine of 296 (3%) offspring had cardiac malformation. Most patients are in New York Heart Association class I, 57% attended college and 15% received an advanced degree.
The data show good results for this group of patients operated on during an early era (1954 to 1960) of open cardiac surgery. They support the current trend toward operation in patients with ventricular septal defects at an early age and with low pulmonary vascular resistance.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to American Journal of Cardiology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- The direct-vision intracardiac correction of congenital anomalies by controlled cross circulation. Results in 32 patients with ventricular septal defects, tetralogy of Fallot, and atrioventricularis communis defects.Surgery. 1955; 38: 11-29
- Physiologic changes after closure of ventricular septal defects.Lancet. 1961; 81: 497-501
- Clinical and hemodynamic changes after closure of ventricular septal defects.JAMA. 1968; 205: 822-827
- Pre and postoperative cardiac catheterization in 200 patients undergoing closure of ventricular septal defects.Surgery. 1968; 63: 69-76
- High-pressure ventricular septal defects.JAMA. 1969; 188: 246-260
- Post-operative follow-up of patients with ventricular septal defect.Circulation. 1974; 50: 465-471
- Predictive value of lung biopsy in ventricular septal defect: long-term follow-up.J Am Coll Cardiol. 1986; 8: 1113-1118
- Prognosis for patients with ventricular septal defect and severe pulmonary vascular obstructive disease.Circulation. 1968; 38: 129-135
- Haemodynamic studies after repair of ventricular septal defect.Br Heart J. 1969; 31: 63-71
- Effects of surgical closure of ventricular septal defects upon pulmonary vascular disease.Br Heart J. 1969; 31: 246-260
- Ventricular septal defect. Incidence, morbidity, and mortality in various age groups.Br Heart J. 1971; 33: 81-87
- Closure of pulmonary hypertension following surgical closure of ventricular septal defect.Adv Cardiol. 1974; 11: 131-134
- Ventricular septal defect with increased pulmonary vascular resistance. Late results of surgical closure.Am J Cardiol. 1974; 33: 403-409
- The fate of raised pulmonary vascular resistance after surgery in ventricular septal defect.in: Rowe RD Kidd GSC The Child with Congenital Heart Disease After Surgery. Futura Publishing, Mt. Kisco, New York1976: 299-312
- Functional status of patients with large ventricular septal defect and pulmonary vascular disease 6 to 16 years after surgical closure of their defect in childhood.Br Heart J. 1977; 39: 1093-1101
- Clinical course in ventricular septal defect.Circulation. 1977; 56: I-56-I-69
- Conduction disturbances before and after surgical closure of ventricular septal defect.Am Heart J. 1969; 77: 123-131
- Post-surgical left anterior hemiblock and right bundle-branch block.Br Heart J. 1972; 34: 263-270
- Late postoperative conduction disturbances after repair of ventricular septal defect and tetralogy of Fallot.Circulation. 1974; 49: 214-221
- Conduction disturbances after surgical closure of ventricular septal defect.Br Heart J. 1972; 34: 1199-1204
- Surgical bifasicular block.Circulation. 1975; 52: 82-87
- Etiology of right bundle-branch block pattern after surgical closure of ventricular septal defects.Am Heart J. 1975; 90: 14-18
- Conduction defects, ventricular arrthythmias, and late death after surgical closure of ventricular septal defect.Br Heart J. 1982; 47: 305-315
- Surgical correction of ventricular septal defect: anatomic and technical consideration.J Thorac Cardiovasc Surg. 1957; 33: 45-59
- Surgically induced right bundle-branch block with left anterior hemiblock: an ominous sign in postoperative tetralogy of Fallot.Circulation. 1970; 46: 587-594
- Postoperative left anterior hemiblock and right bundle branch block following repair of tetralogy of Fallot. Clinical and etiologic considerations.Circulation. 1975; 51: 1026-1029
- Control of complete heart block by the use of an artificial pacemaker and a myocardial electrode.Circ Res. 1958; 6: 410-415
- Transistor pacemaker for treatment of complete atrioventricular dissociation.JAMA. 1960; 172: 2006-2010
- Incidence of bacterial endocarditis in ventricular septal defect.Circulation. 1966; 34: 127-131
- Natural history of ventricular septal defect. A study involving 790 cases.Circulation. 1977; 55: 908-915
- Surgical treatment of ventricular defect.J Thorac Cardiovasc Surg. 1960; 40: 763-775
- Results of repair of ventricular septal defect.J Thorac Cardiovasc Surg. 1966; 52: 486-501
Accepted: July 25, 1991
Received: May 21, 1991
☆This study was supported by the Paul F. Dwan Chair in Education in Pediatric Cardiology.
© 1991 Published by Elsevier Inc.