British heart journal
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British heart journal · Oct 1975
Quantitative structural analysis of pulmonary vessels in isolated ventricular septal defect in infancy.
Structural changes in the pulmonary circulation were studied in the lungs of 5 infants dying with ventricular septal defect. Applying precise quantitative morphological techniques to the pulmonary vessels, it was possible to correlate pathological change with clinical and haemodynamic findings, and to identify two patterns of response. Three of the infants (group I) ppresnted in cardiac failure with a large pulmonary blood flow, dilated and tortuous pulmonary arteries, and fewer intra-acinar vessels than normal. ⋯ The findings illustrate the variation in pulmonary vascular response in infants with a ventricular septal defect. It is suggested that in patients with a ventricular septal defect, arterial muscularity usually regresses after birth and a left-to-right shunt develops; secondary hypertrophy of the media then develops in reaponse to the shunt. Our findings also suggest, however, that in some infants arterial muscle fails to regress postnatally so that pulmonary blood flow is never high and a right-to-left shunt develops soon after birth.