Untreated, Low-Pressure Ventricular Septal Defect

The choice of treatment in ventricular septal defect is based on observation of the natural history of this entity. A number of authors * have reported the progress of untreated patients with isolated ventricular septal defect, indicating a spectrum of possibilities varying from spontaneous closure to progression of pulmonary hypertension. We are reporting our studies of ventricular septal defect in 32 children below the age of 12 years at the time of initial observation. Most of them were asymptomatic with pulmonary arterial systolic pressure below 30 mm Hg. Catheterization and cineangiography were repeated from one to seven years after the initial studies. In two instances, a third set of observations followed the second by three to five years. Method Right heart catheterization was performed in the usual way, by venous cutdown or by percutaneous venipuncture in the groin. Pressures and intracardiac oxygen saturations were obtained from various chambers and cineangiograms in