Follow-up study into early adulthood of patients with congenital heart diseases

Patients with congenital heart diseases (CHD), who had been under our management during school days (elementary, junior high and senior high schools), were followed up into early adulthood (20-38 years in age, averaging at 27.3 years) to obtain the following results. (1) The course of mild CHD until early adulthood was favorable in terms of fatality rate. However, the incidence of complication and resultant deterioration was higher in non-operated mild CHD cases than in operated CHD cases. Representative complications in mild ventricular septal defect (VSD) cases were infectious endocarditis and aortic incompetence (often found in type I VSD cases). A chief complication in mild atrial septal defect (ASD) cases was prolapse of the mitral valve. (2) Patients with VSD or PDA (particularly mild cases) showed spontaneous recovery even in early adulthood. (3) The prognosis of non-operated CHD cases of moderate or higher severity was evidently poor compared to that of mild or operated cases. These results suggest that surgery is indicated in all CHD cases of moderate or higher severity so long as surgery is possible.