Text Box: THE PROGNOSIS OF PATIENTS WITH VENTRICULAR SEPTAL DEFECT ACCOMPANIED BY MITRAL INSUFFICIENCY SHENG Feng, LI Zipu, LIU Yuyang, CHEN Zhanggen Children’s Hospital of Fudan University, Shanghai, China Objective: Ventricular septal defect (VSD) is the most frequently congenital heart disease. Some patients with VSD are accompanied by mitral insufficiency (MI). The post-operative MI is a much more important cause resulting in congestive heart failure. But it is still unclear whether MI will disappeared after VSD closure procedure. The purpose is to study the relationship between early VSD closure and the post-operative MI. Methods: 295 cases with VSD, MI were chosen for study from Feb. 1990 to Feb. 1998. Patients aged from 10 day to 12 year old, mean age was 2.6 year old. There were 223 patients with congestive heart failure (CHF). Results: The more severe MI, the more severe CHF. The more large size VSD and left to right shunt, the more severe MI. 126 patients were performed surgical VSD close and 169 patients received medicine therapy including digoxin and captopril. There are no significant differrences between two groups in age, sex, sevirity of MI before surgery. The follow-up period varied from 6 months to 34 months. After surgical VSD closure, MI disappeared in 99 patients, diminished in 5 patients, MI unchanged in 22 patients. After medicine therapy, MI disappeared in 69 patients, diminished in 13 patients, unchanged in 83 patients, and deteriorated in 12 patients. Conclusion: After surgical VSD closure in patients with VSD, MI, MI in most patients disappeared or diminished, but MI disappeared or diminished only in about half patients without surgical VSD closure, MI remained unchanged in a half patients and even worse in 12 patients. So early VSD closure is necessary for patients with VSD, MI. 1863