Ventricular Septal Defect (cont.)
John Mersch, MD, FAAP
Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is a ventricular septal defect (VSD)?
- How common is a VSD?
- What is the normal design of the heart?
- How do VSDs cause problems?
- How is a VSD diagnosed? What are the symptoms of a VSD?
- What if the VSD is small?
- How is a small VSD treated?
- What if the VSD is large?
- How is a large VSD treated?
- What types of surgery are available to correct a VSD?
- What is the outlook (prognosis) after a VSD is repaired?
- What are complications of VSD surgery?
- What about unusual cases of VSD?
- What are long-term precautions with VSDs?
- Ventricular Septal Defect At A Glance
- Find a local Cardiologist in your town
What types of surgery are available to correct a VSD?
There are two types of surgery available to correct a VSD: the intra-cardiac technique and the trans-catheter technique. Which surgical technique is chosen is an individualized decision based upon the nature of the VSD and associated side effects on the patient's heart and lungs. The intra-cardiac approach is the most common technique and is done while the patient is under cardiopulmonary bypass (a "heart-lung machine") and is an open-heart operation. This is the procedure of choice for most children and at most pediatric surgical centers. Another technique uses surgical instruments that are passed through catheters placed in the patient's large blood vessels into the heart. This "trans-catheter approach" is generally more difficult and should only be considered on select patients and at pediatric centers that have expertise in such a procedure.
What is the outlook (prognosis) after a VSD is repaired?
After a successful surgical repair of the VSD, the two ventricles are entirely separate from each other and the circulation of the blood within the heart is normal. If the heart was enlarged, it can return toward normal size. The high pressure in the pulmonary artery should also begin to resolve. If the child's growth had slowed, the child usually catches up within a year or two. Long-term follow-up is required. The long-term prognosis is usually excellent.
What are complications of VSD surgery?
Complications with intra-cardiac VSD surgery are uncommon. Currently, most centers have an operative mortality rate of less than 1% if the VSD is the only defect and the heart is functioning normally. Major complications are rare (1%-2%) and include heart rhythm problems and incomplete closure of the VSD. Rarely, a pacemaker insertion or a second procedure to repair the defect are necessary.
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