Ventricular Septal Defect (VSD)
Ventricular Septal Defect or VSD is a hole in the wall seperating the two lower chambers of the heart. (As pictured above.)
What Can Be Done About VSD
If the opening is small it won't make the heart and lungs work harder, surgery and other treatments won't be necessary. Small VSDs often close on their own. There isn't any medicine or other treatment that will make the VSD get smaller or close any faster than it might do naturally. If the opening is large open- heart surgery may be needed to close it and prevent serious problems. Babies with VSD may develop severe symptoms and early repair, within the first few months, is often necessary. Medincines may be used to temporarily help with symptoms but can't cure VSD or prevent permanent damage to lung ateries.
Procedure done
Usually a patch of fabric or pericardium (the normal lining around the outside of the heart) is sewn over the VSD to close it completely. This patch is later covereved by the normal heart lining tissue and will become a permanent part of the heart. Although some defects can be sewn closed without a patch, it may be possible to close some VSDs in the cath lab.
How does the VSD Affect me
Most children had surgery to close the defect, therefore large VSDs in adults are uncommon but when they are present can cause shortness of breath. Most adults have small VSDs that don't usually cause symptoms because heart and lungs don't have to work harder. In physical examinations small VSDs produce a loud murmur. Occasionally small VSDs may be a source of infection called endocarditis.
Additional information
Patients with repaired VSDs and normal pulmonary artery pressures have normal lifespans. Later problems are uncommon but a small number of patients may have problems with the heart valves ( aorta or tricuspid) or extra muscles inside the right side of the heart. In a patient with a large unrepaired VSD Pulmonary Hypertension can occur.
What if the defect if still present? Should it be repaired in adulthood?
Usually closure is recommended for small VSDs only if there's been an episode of endocaditis which is a heart infection that may be due to the VSD or if the location of the VSD affections the function of one of the heart valves. If the VSD is large the pressure in the lungs determines whether it can be closed in an adult patient. Though those with low lung pressure will benefit from surgery, those with high pressures may or may not.
Problems you may have
Patients with small VSDs that stay open have a small risk of a heart infection. The aortic valve may develop leakage and should be monitored. Patients whose VSD had been repaired early in their life are unlikely to have any significant long-term problems. If the Ventricular Septal Defect is completely closed without a leak in the patch the risk of late infection is minimal. Abnormal heart rhythms can occur rarely. The heart muscle may be less able to contract folling a VSD repair in some patients. If heart failure develops as a result of the heart muscle and weakness, diurectics to control fluid accumulation aganets to help the heart pump better and drugs to control blood pressure are often given.