Ventricular septal defect

Diagnosis

VSD may be detected during pregnancy when an ultrasound examination or a special heart imaging investigation is performed on the fetus’s heart. A heart murmur is often the first indicator of ventricular septal defects (VSDs). Your doctor will use a stethoscope to listen to your baby’s heart to check for a heart murmur or other signs and may request several further investigation which include:

• Echocardiogram: a noninvasive test which uses sound waves to produce real time images of the heart and is used by doctors to identify and assess the size, location, and severity of a ventricular septal defect as well as other abnormal structure of the heart.
• Electrocardiogram (ECG): uses sensors that record the electrical activity of the heart allowing the doctor to see an abnormal rhythm and if the heart muscle is experiencing stress.
• Chest X-ray: shows the heart and lungs and the changes in the lungs due to extra blood flow and the abnormal size of the heart.
• Cardiac catheterization: the doctor inserts a very small, flexible, hollow tube (called a catheter) into a blood vessel in the groin, arm, or neck and then passes it up to the heart to obtain information about the heart and its vessels which provides better diagnosis on any underlying congenital heart defect.
• Pulse oximetry: use of a small clip placed on a fingertip that measures and monitors blood oxygen level.

Treatment

Many infants with a minor ventricular septal defect (VSD) at birth will not require surgery to close the opening or hole and instead should be monitored after birth to treat any symptoms that may occur while waiting to see if the defect closes on its own.

Surgery for babies who require it is frequently performed during the first year of life. It could be required to close a ventricular septal defect in children and adults who have a medium or large defect or one that is producing noticeable symptoms.

The location of the VSD can also create complications such as damage to heart valves. To avoid these issues, smaller VSDs may need to be surgically repaired if indicated. Many persons with mild VSDs lead fulfilling lives with minimal concomitant problems.

Babies with large VSDs or babies who become easily exhausted during feeding may require additional nutrition support to their growth. It is possible that some infants will need medicine to manage heart failure.

Medications

The severity of heart failure symptoms affects the medications given for ventricular septal defect which are used to lessen the volume of fluid in the lungs and bloodstream. Medications include diuretics, such as furosemide. Some medicines can also help strengthen the heart muscle and lower blood pressure.

Surgeries or other procedures

The goal of the surgery is to correct ventricular septal defect through plugging or patching the hole between the heart’s lower chambers. If you or your child needs surgery to fix a ventricular defect, it is essential that you have surgeons and cardiologists who have the experience to carry out the operation.

Procedures to repair VSD may include:

• Surgical repair: This procedure typically requires an open-heart surgery while undergo general anesthesia. A chest incision and a heart-lung machine are required for the procedure. Depending on the size and location of the hole, the doctor may stitch to close the hole or patch it using a graft.
• Catheter procedure: Chest incision is not required in performing catheterization to fix the ventricular septal defect. Instead, the physician places a thin tube (catheter) into a groin blood vessel and directs it into the heart. The hole is subsequently sealed by the doctor using a mesh device called an occluder. Not all VSDs can be closed using this method.

The cardiologist will set up routine check-ups to make sure that the ventricular septal defect stays closed and monitor for any possible complications. Frequency of visits of the child will based on the severity of the condition and the existence of any additional issues. The doctor will also provide with instructions on how to take care of the child. Ideally, children should be fully recovered few weeks after the surgery.