Surgery of ventricular septal defect and pulmonary vascular resistance.

In a series of 65 patients operated upon for ventricular septal defects (VSD), no mortality was attributed to pre-operative raised pulmonary vascular resistance. Eight patients with a severe degree of pulmonary vascular resistance made a full recovery after surgical closure of the ventricular septal defect. Three patients were cyanotic at the time of operation. Mortality in the series was the result of inadequate perfusion during operation, haemorrhage, cardiac tamponade, mediastinal infection, complete heart block or the development of post-operative aortic incompetence. Raised pulmonary vascular resistance and clinical evidence of a dominant left-to-right shunt in the absence of serious intracardiac anatomical complications does not contraindicate surgery for the repair of VSD.