Left-to-Right Shunts in Infancy and Childhood

Abstract

Infants with ventricular septal defect who need surgical help are best treated by banding of the pulmonary artery. In older children the defect can be closed surgically, but it should be given a chance to close spontaneously unless pulmonary vascular disease occurs. Patent ductus arteriosus, however, should be closed surgically, because after infancy spontaneous closure is rare. Prophylactic closure of a medium or large atrial septal defect (secundum) is recommended, usually between five and 10 years of age.