Overview
What is a VSD?
The septum is a wall that separates the heart's left and right sides. Septal defects are sometimes called a "ho le" in the heart. A defect between the heart's two lower chambers (the ventricles) is called a ventricular septal defect (VSD).
A ventricular septal defect (VSD) is a hole in the wall (septum) that separates the heart’s two lower chambers (ventricles). Ventricular septal defects usually occur by themselves, without other birth defects of any kind. Experts estimate that VSDs account for about 30 percent of all congenital heart defects, occurring in 1 out of every 500 babies.
What are the symptoms of VSD?
The symptoms and treatment for VSD depend on the size of the hole and where it is located. The size of the defect determines its effects on the heart’s function. When the opening between the ventricles is large, oxygen-containing blood flows backwards into the right ventricle instead of out into the body. From the right ventricle, this oxygen-containing blood gets pumped back to the lungs, displacing blood in the lung circulation that needs oxygen. This inefficient blood flow causes the heart to pump harder, trying to compensate.
As a result, the heart may enlarge and high blood pressure may develop in the arteries of the lungs (pulmonary hypertension). A person with a large VSD may experience shortness of breath, fatigue and weakness.
How is VSD diagnosed?
Ventricular septal defects frequently are diagnosed at birth or within a few days from birth because the doctor can hear the distinctive murmur. Older children or adults with an undetected VSD may experience shortness of breath with exercise or heart rhythm problems that send them to a doctor. Diagnosis may include:
Chest x-rayElectrocardiogram to evaluate the heart’s electrical systemTransthoracic Echocardiogram with Doppler imaging: Ultrasound images are obtained to show the size and function of the heart’s chambers, assess the condition of the heart valves and measure the velocity of blood flow across the VSDCoronary angiography in patients at risk of coronary artery disease or in patients over age 40 if a surgical repair is planned.MRI to detect other associated cardiac abnormalities
Does VSD always require treatment?
Approximately 75 percent of small VSDs close on their own within the first year of life or by age 10 and do not require any treatment other than careful monitoring. For medium to large VSDs, the spontaneous closure rate is about 5 to 10 percent. If a VSD has not closed by age 10, spontaneous closure probably will generally not occur; it is rare for a VSD in an adult to close on its own.
An adult who has a VSD without any symptoms probably does not require intervention but should have regular checkups by a physician who specializes in adult congenital heart disease. Although the VSD may not be causing heart or lung problems or symptoms, adults with unrepaired VSDs still have a higher than normal risk for heart valve problems and endocarditis, a potentially life-threatening infection of the heart.
What is the success rate for VSD surgery?
Surgical closure of VSDs did not become a widespread procedure until the 1960s, so long-term data on outcomes and life expectancy is only now being collected and analyzed. Available data indicate that adults with closed VSDs and without other heart or lung complications can expect to live a normal lifespan. In the 40 years that the operation has been widely used, about 6 percent of patients have required a re-operation to close small leaks that developed around the patch. Are there any long-term problems or complications after surgery?
Within the first six months after surgical repair of a VSD, the person still has a risk of endocarditis while the heart heals. Your cardiologist can advise you on how to protect yourself from this life-threatening condition.
People with repaired VSDs may develop cardiac arrhythmias later in life, caused by scar tissue that develops ion the heart from the VSD surgery. Several effective treatments are available for arrhythmias; your cardiologist can advise whether your arrhythmia requires treatment. The risk of arrhythmias and sudden cardiac death is higher in patients who have undergone VSD repair late in life.
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