[Pulmonary stenosis with intact ventricular septum. Surgical experience in 200 cases, excluding the neonatal period].

Experience over 10 years, studying two groups of patients (group I: 79 cases aged between 2 months and 2 years, group II: 151 cases aged over 2 years) has shown that the operative prognosis of severe forms is now the same as in simple forms. Interest is now focused on the long term function of the right ventricle with regard to the surgical procedure. The main discussion in management is between isolated pulmonary commissurotomy, whatever the anatomical form, and operations such as we perform which associate ventricular resection with or without an infundibular patch in severe cases. The possible causes of late ventricular dysfunction are discussed, especially the muscular resection, the operative myocardial protection and the preoperative myocardial sclerosis. The good results observed in this series as opposed to the doubt as to the cause and variability of late ventricular dysfunction do not justify a change in our management at present.