Abstract
The signs of obstructive lung disease dominated the clinical course of ten infants with ventricular septal defects and large left-to-right shunts. Airway obstruction in these patients can be attributed (1) to increase in large airway resistance as the result of compression by enlarged pulmonary arteries or cardiac chambers and (2) to increase in small airway resistance as the result of accumulation of peribronchiolar fluid. The rapid regression of the signs of obstructive airway disease following open heart repair of the ventricular septal defect indicates that the lung disease observed in these infants is secondary to the ventricular septal defect, rather than a primary process. The most effective management in the refractory patients is that of open repair of the defect.
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