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To the Editor: In their article about prospects for cardiovascular research, Drs Lefkowitz and Willerson¹ state that, "l million infants are born each year with heart defects." This figure seems extraordinarily high. Estimates of the incidence of congenital heart disease in live newborns vary from 4.1/1000 to 12.3/1000.² Assuming that approximately 4 million infants are born in the United States annually,³ this would represent between 16 200 and 49 200 new cases of congenital heart disease each year. Even including small ventricular septal defects that close spontaneously within the first year of life and clinically mild cases of bicuspid aortic valves and pulmonary stenosis, the highest incidence ever postulated is 8%, or 320 000 annually.²

Indeed, the total US prevalence of congenital heart disease, estimated by Hoffman,² is only slightly more than l million: 643 000 in those younger than 20 years and about 400 000 in those 21 years or older. I would appreciate . . . [Full Text of this Article]

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