Functional Closure of the Ventricular Septal Defect After Pulmonary Artery Banding: An Unusual Late Complication

A 9-week-old infant with a large ventricular septal defect (VSD) underwent successful banding of the pulmonary artery with clinical improvement. Spontaneous functional closure of the VSD later developed and, at age 4 1/2 years, the clinical and hemodynamic findings were those of severe isolated pulmonary stenosis with right ventricular failure. Severe right ventricular hypertrophy appearing late in the postoperative period should alert one of the possibility of a spontaneously closing VSD.