Spontaneous Closure of a Membranous Ventricular Septal Defect

Abstract

Complete anatomical closure of a high ventricular septal defect by the medial tricuspid leaflet as an accidental finding at necropsy was reported for the first time in 1952 by Hartmann from the Pathological Anatomical Institute in Vienna (Professor H. Chiari).In 1960 Majka and associates reported a case of " spontaneous repair of a ventricular septal defect " which came to necropsy at our hospital.Recently a virtually identical case was discovered accidentally at necropsy on an 86-year-old man.This unusual finding is presented together with its surgical application. Case Discovered at NecropsyThe patient had been at Westminster Hospital for Domiciliary Care from June, 1956.until his death in December, 1961.His previous history was rather vague, but it appeared that he had suffered from frequent upper respiratory-tract infections and pneumonia.On admission and several times during his stay in hospital he was in early heart failure precipitated by respiratory-tract infections.Treatment of the latter and diuretics were sufficient to over- come this problem.Digitalis was not given until April, 1960, when he was aged 84.Physical examination on admission revealed an emphysematous chest, moist rales at both lung bases, and some Elizabeth the Queen Mother is patron and the Princess Royal is the vice-patron of the fund.Since the scholarships were first allocated in 1950, over £40,000 has been spent in this way, and more than 200 scholars have gone out under the auspices of the fund.