In the early experience of any cardiovascular surgical unit utilizing total cardiopulmonary bypass for the repair of complex defects within the heart, there are undoubtedly certain defects incompletely closed. With the increasing experience of the operator, the number of these cases will decrease. However, with the great number of workers repairing these defects, incomplete closure will most likely continue to be a problem for some time to come. It is just such a problem that has stimulated this report.
When the realization that the operative procedure has been a complete failure, usually consisting of the return of hyperdynamic heart action, a thrill, and systolic murmur after the repair of a ventricular defect, certain aspects must be considered. The first of these is, of course, the sincere appreciation that the child has not in any way been benefited by the surgical procedure, no matter how lengthy and exhausting it may have