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Ventricular Septal Defect

Ventricular Septal Defect Treatment

In some children with ventricular septal defect, the defect will close on its own as the child grows.

Medical Treatment

If a larger ventricular septal defect is causing symptoms, your child's health care provider may prescribe medication.

 

  • Which medication is prescribed depends on the severity of symptoms.

  • The goal of therapy is to reduce the symptoms of congestive heart failure, such as poor growth and development, weight loss and/or poor weight gain, excessive sweating, and fast breathing. An older patient typically develops fluid in the lungs, liver, and legs.

  • Routine antibiotic use is warranted for dental surgery and any invasive procedure if any VSD is still present after closure.

 

Medications

  • Vasodilators: Angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers are used to decrease the work load on the left ventricle.

  • Digoxin (Lanoxin) increases the strength of the heart muscle to deal with the greater blood volume.

  • Diuretics such as Lasix (furosemide) or spironolactone help remove excess fluid from the body so the heart doesn't have to work as hard and the patient feels much better.

 

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.

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