[Ventricular Septal Defect in an Elderly Patient:Report of a Case].

Ventricular septal defect (VSD) is one of the most common congenital heart diseases, but untreated cases reaching advanced age are rare. We report a case of an 85-year-old woman with an untreated VSD who presented with dyspnea. Despite the relatively large defect (12×16 mm), she had no prior history of heart failure. Echocardiography and catheterization revealed a left-to-right shunt with mild pulmonary hypertension. Surgical closure was performed using a Dacron patch, and the patient had a favorable postoperative course. The absence of early heart failure was likely due to a hypertrophied trabecular muscle partially covering the defect, limiting the left-to-right shunt. However, as right ventricular hypertrophy progressed, the defect widened, leading to acute heart failure. This case highlights the potential for long-term survival in patients with specific anatomical modifications and underscores the importance of individualized surgical decision-making in elderly VSD patients.