Ventricular Septal Defect

Signs and Symptoms

Small ventricular septal defects (VSD) typically don't cause symptoms. However, larger VSDs may cause congestive heart failure and the following symptoms because the heart works harder than normal.

• An enlarged heart caused by pumping extra blood
• High blood pressure in blood vessels in the lungs, which over time could permanently damage vessel walls
• Shortness of breath and sweating
• Significant fatigue
• Trouble eating and gaining weight

Diagnosis

To diagnose ventricular septal defect, your childs doctor will conduct a thorough medical exam. The following tests also maybe performed:

• Chest X-ray to see the heart's size
• Echocardiogram, a test that uses sound waves to create a moving picture of the heart.
• Electrocardiogram (ECG or EKG), a test that records the electrical activity of the heart.
• Magnetic resonance imagining (MRI) or computed tomography (CT) scan may performed to better see the restricted area and surrounding blood vessels

Treatment

Many ventricular septal defects (VSD) are small and close on their own during childhood and adolescence without treatment. However, larger VSDs and those causing heart problems require repair, preferably in the first two years of life before serious heart problems develop.

Depending on the size and location of the VSD, open-heart surgery or a less invasive procedure using a synthetic patch will be used for repair.

VSDs repaired with a synthetic patch use a technique called cardiac catheterization, which is performed in our Pediatric Cardiac Catheterization Laboratory.

A catheter is a thin, flexible tube inserted through a tiny incision in the groin into the blood vessels and threaded through the vessels to the heart. Catheters can carry devices to patch the heart.

Several devices are available to patch holes in children's hearts. The type and size of the device is chosen after X-ray and echocardiogram images determine the size and location of the hole. Sometimes more than one device is needed to close the hole.

During cardiac catheterization, a folded patch is guided through the catheter until it reaches the proper position. It is unfolded to fit over the hole in the heart. The procedure takes about three hours. Most patients stay overnight in the hospital and go home the next day.

Within three months, the lining of the heart wall grows over the patch and seals the hole. Patients take medication, usually daily aspirin, for six months after the patch is placed to thin the blood and prevent blood clots while the heart heals.