Repair of ventricular septal defect in the first year of life.

In the 7-year period 1976 through 1982, 48 infants underwent repair of ventricular septal defect (VSD). Their mean age was 5.3 (range 1-11) months and mean body weight 5.4 (range 3.1-9.6) kg. "Uncomplicated" VSD, located in the membranous septum, was present in 33 cases. "Complicated" VSD in terms of muscular/multiple (n = 6), subaortic type of double-outlet right ventricle (n = 5), AV-canal type (n = 2) and straddling chordae (n = 2) was present in 15 cases. The indication of surgery was progressive left ventricular dysfunction due to pulmonary hyperperfusion and pulmonary hypertension. Right trans-atrial exposure permitted repair, patch or tunnel in 43 of the 48 infants (90%), although temporary detachment of the septal tricuspid leaflet was required on six occasions. Co-existing patent ductus arteriosus (n = 6) and atrial septal defect (n = 22) were simultaneously closed. There were three postoperative deaths (6%). One infant required a second-stage repair for incomplete VSD closure and one sustained a permanent AV-block II. Repair via right atrial exposure was associated with few complications and only one death (2%).