Interventricular communication in the infant is presently treated by complete surgery under extracorporeal circulation and hypothermia. Improved techniques in surgery, anesthetics and resuscitation explain a low, acceptable, level of postoperative morbidity; it is estimated by most authors at 3-4% during the first six months of life. Postoperatively, acute pulmonary arterial hypertension is to be feared, resulting in low cardiocirculatory flow from right ventricle failure. In a group of 20 infants who underwent IVC surgery, the authors have observed two cases of this complication, one being lethal. Its treatment is based on the administration of alpha-blocking vasodilating agents, which can be associated or not with exogenous bêta I-adrenergic catecholamines. Results could probably be improved by preventing such acute postoperative pulmonary arterial hypertension.
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