[Pulmonary insufficiency in childhood. Contribution to diastolic murmurs (author's transl)].

Diastolic murmurs in childhood are in most cases due to pulmonary insufficiency. They may be functional (Graham-Steel-murmurs, for instance with idiopathic pulmonary ectasis or pulmonary hypertension), but are more and more the symptom of postoperative pulmonary insufficiency. Diastolic murmurs of pulmonary insufficiency were found after operations of valvular and infundibular pulmonary stenosis in 92,5% of the cases (40 children) and after total correction of tetralogy of Fallot in 89% of 27 children. The diastolic murmur of pulmonary insufficiency is very good recorded in phonocardiography; with postoperative heart catheterisations and angiocardiography there is good estimation of the degree of the pulmonary insufficiency. There is no doubt about the curative effort of operations in these congenital heart defects, and postoperative pulmonary insufficiency does not impair the operative improvement in childhood. Till now long term observations of these cases up to late adulthood cannot be possible; regular pediatric cardiologic examinations of these operated children are mandatory.