Natural history of ventricular-septal defects associated with ventricular-septal aneurysms

The diagnosis of ventricular-septal aneurysm was established by left ventricular cineangiography in forty-four patients. Six of the patients had a ventricular-septal aneurysm without a ventricular-septal defect at the time of their initial catheterization. Twenty-seven patients who had a ventricular-septal defect and ventricular aneurysm as their only significant cardiovascular lesion were followed for a mean of four years and ten months. The left-to-right shunt ratio was less than 1.5:1 in all cases. Shunt size decreased in six out of seven patients subjected to repeat catheterization. In no case were we able to document complete closure of the ventricular-septal defect. Thus, although a ventricular-septal aneurysm may represent a mechanism for partial closure of a ventricular-septal defect, complete closure of the defect appears unlikely if it remains open past the first few years of life.