The Natural History of Ventricular Septal Defect
Progress rept. 1 Jul 1961-30 Jun 1962
WALTER REED ARMY INST OF RESEARCH WASHINGTON DC
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There is great medical difference of medical opinion concerning the natural history of ventricular septal defect. All cardiologists have been impressed with the frequence with which it is encountered in pediatric cardiac clinics and its infrequency in adult cardiac clinics. Some surgeons have argued that this indicates a lethal disease with few patients surviving to adult life hence, an aggressive surgical policy to close all ventricular septal defects should be pursued. However, beyond the first year of life there are few reported autopsied patients who die from ventricular septal defects. Several reports suggest that some ventricular septal defects spontaneously close also that the defect does not increase in size as the heart grows, suggesting that defects may become hemodynamically insignificant with he passage of time. Since the surgical correction of interventricular septal defect is associated with a rather high mortality rate in infancy and early childhood, it is imperative to clarify the natural course of the disease, in order to decide whether the present risk of surgical closure is justified in this group of patients. In this study, all Army Teaching Hospitals are pooling their material to carry out a comprehensive follow-up study on all cases of interventricular septal defect in their files proven by cardiac catheterization prior to 1 January, 1960. The follow-up includes present status of health, the number who have died from their disease and the autopsy findings where available, the number who have had surgical correction, the number who have died incident to surgery, a determination as to whether any have undergone spontaneous closure of their defect, height and weight for plotting growth curves, a determination of cyanosis, etc. In patients who have not had surgery, repeat cardiac catheterization is considered in evaluating the hemodynamics alterations and changes in magnitude of the shunt with the passage of time.
- Anatomy and Physiology
- Medicine and Medical Research