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Ventricular Septal Defect

Surgery

Larger ventricular septal defects do not close as the child grows. If it does not close, closing the heart surgically is necessary.

 

  • Surgical closure is typically done before the child begins preschool.

  • Surgery is indicated if medications do not work in the first few months or years of life, especially if the child is not growing adequately even with medications.

  • Surgery is more urgent if evidence of pulmonary hypertension has developed.

  • The most used operation involves placing a Gore-Tex patch over the hole. This prevents shunting (the movement of oxygenated blood from the left to the right ventricle).

Surgery is not usually performed in newborns because small defects will close spontaneously in 20%-25% of cases. The surgery also is more risky in the first few months of life; the risk of death from the operation is higher in the first 6 months of life.

Researchers are testing devices that cover the defect, performed in the cardiac catheterization laboratory, not by open heart surgery.

Next Steps - Follow-up

  • Regular office visits and echocardiograms are required to continually reassess the ventricular septal defect.
  • The child's weight and length/height will be checked often. Feeding and activity levels should be assessed routinely.

  • Routine antibiotic use is warranted for dental surgery and any invasive procedure.

Prevention

A woman can do nothing during pregnancy to prevent her baby from developing a ventricular septal defect.

Outlook

During the growth of a child, the defect may become smaller and close on its own.

  • Twenty to 25% of all ventricular septal defects close by age 3 years without medical intervention.

  • Children who show no symptoms and are being monitored by a primary care provider do not have to restrict their activities. Children with mild-to-moderate shunting of blood may have to reduce their levels of activity.

  • Once a defect is repaired, there are no restrictions on activity.

Several other conditions may result from ventricular septal defects.

  • Aortic regurgitation: Blood flowing backward from the aorta into the left ventricle.

  • Endocarditis: An infection of the heart valves due to abnormal blood flow. Because endocarditis is always possible, medical professionals may recommend that children with certain types of ventricular septal defects receive antibiotics before undergoing dental procedures or surgery.

 

  • Pulmonary hypertension: An increase in pressure in the right side of the heart and in the arteries of the lungs. This is caused by the shunting of blood from the left to the right ventricle, which increases the pressure in the right ventricle.

For More Information

American Heart Association
National Center
7272 Greenville Avenue
Dallas, TX 75231

Web Links

MedlinePlus, Ventricular septal defect

American Heart Association, Ventricular Septal Defect (VSD)
 

Synonyms and Keywords

ventricular septal defect, atrial septal defect, congenital heart defect, heart murmur, hole in the heart, leaking heart, left to right shunt, shunting, VSD, aortic regurgitation, endocarditis, pulmonary hypertension

WebMD Medical Reference from eMedicineHealth

Reviewed by James Beckerman, MD, FACC on April 23, 2014
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