The natural history of ventricular septal defects in infancy.

摘要: Abstract Sixty-two infants with ventricular septal defects were first catheterized under 1 year of age and followed up for one to five years; 40 recatheterized. Thirty-six born in the Bronx Municipal Hospital Center or Lincoln (local group). These patients unselected, that decision catheterize them was based only on clinical diagnosis a defect not an assessment its size presence symptoms. As far as we know, these include most if all children hospitals during period study. With this assumption, incidence per 1,000 live births 0.94 full term infants, 4.51 premature 1.35 whole group. Twenty-six other referred from doctors (referred group), and, compared local group, they had larger defects, more often congestive heart failure after 6 months age. In series, 31 62 failure. This began before occurred much earlier than infants. spontaneous functional closure took place 13 36 (36%); proved by recatheterization 10 autopsy 1. Marked decrease another (28%). group (26 cases) there 2 (8%) closures 7 (27%) reductions size. For 52 cent which known have closed become smaller; 32 doing well clinically (most recatheterized so some might smaller); 16 seriously affected their lesions. Complete between 12 age, when small, but it could occur large defects. Decrease size, however, frequently small found many pulmonary arterial hypertension. The who did do included 4 banding severe, uncontrolled (2 died); baby died at weeks severe failure; 5 very high vascular resistance. One resistance month old, change significantly 4, low 3, 6, 11 respectively, significant rises pathologic levels 9, 15, 26 respectively. suggests rise infancy is rare big that, even children, does usually persist level present birth falls post natally normal rising. left right shunts, atrial pressures marked 3 out whose resistances rose catheterization, no distinctive indications detected recatheterization. child increasing hypertrophy electrocardiogram. From findings suggest since reduction common, should be treated conservatively hope improvement will occur. If cannot controlled, then surgical artery done. If, can controlled medically, infant Whether occurs not, six nine initial catheterization determine has occurred; surgery advised.