VSD is the most common left to right shunt lesions.
VSDs can be easily diagnosed antenatally by fetal echocardiography. However, sometimes it can be missed by fetal echo depending upon fetal position etc.
Clinical presentation depends on size of VSD. Most commonly around one month of age if size of VSD is large. Mostly comes with complaints of poor weight gain, poor feeding, excessive sweating etc.
Management of VSD
It depends on size of the VSD. If size of VSD is small and patient is asymptomatic, then mostly no treatment is required. In case of aortic valve leakage or infective endocarditis: early treatment is required.
In moderate sized VSD: patient may be having signs of failure to thrive and this type of VSD can be treated by either surgery or if suitable then by the device method also.
Large VSD has to be closed within 3 to 6 months of age by surgery
Few VSDs like muscular VSDs and perimembranous VSD restricted by tricuspid tissue may close spontaneously
Can we close VSDs by without surgery (angiographically by transcatheter method)?
Yes, if size, location of VSD is such that it can accommodate device without causing trouble to the adjuscent structures then VSD also can be closed by the device as we can close ASDs by device. Generally we prefer weight of child to be in the range of 5-6 Kg.