In selected cases, early corrective surgery is indicated in the management of infants having large ventricular septal defects. The risk of any surgical procedure in infancy is acknowledged to be great and should be avoided whenever possible.
However
this greater surgical risk is justified when the patient presents with intractable congestive heart failure, severe pulmonary hypertension, marked growth retardation, and recurrent prolonged lower respiratory infections. We analyzed 31 patients
with
ventricular septal defect in infancy who underwent surgical correction from January 1991 through December 1994. Age ranged from 6 months to 12 months with mean age of 9.2 months. Of the thirty-one patients, 23 patients were male and 8 patients
were
female. Mean body weight was 7.4kg. The most common type of ventricular septal defect was perimembraneous(64.5%). Associated cardiac anomalies were found in 17 patients(55.8%). Mitral regurgitation was the most commonly associated cardiac
anomaly(16.1%)
and followed by patent ductus arteriosus (12.9%). When cardiac catheterzation data were analysed, the most common range of Qp/Qs, Rp/Rs, Pp/Pp were 2.1~3.0, 1-0.25, above 0.70 respectively. Among the indications of surgical correction, there were
pulmonary hypertension in 20 patients, congestive heart failure in 3 patients, intractable respiratory infection in 10 patients and growth retardation in 14 patients. The mots common surgical approach and method for closure of ventricular septal
defect
were right atriotomy(58%) and Dacron patch closure(94%). Postoperative complications occurred in 10 cases(32%) and overall mortality was 12.9%(4 cases). All operative deaths in this series occurred in infants under the age of 8 months and weight
of
8
kilograms.
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