Abstract
Twenty-two of 370 patients undergoing closure of ventricular septal defect required reoperation to close a residual defect. These defects tended to be in the posteroinferior angle of the defect, and the recurrence was never due to tearing of the prosthetic patch but always to failure of the sutures to hold securely in the perimeter of the defect. Closure of the recurrent defect was advised when the left-to-right shunt exceeded 2:1 or when significant right ventricular outflow obstruction remained due to unrelieved obstruction in Fallot's anomaly or to cicatricial stenosis following removal of a pulmonary artery band. The second operations were less hazardous than had been feared and yielded satisfactory results in all but 1 of the survivors.
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