Ventricular Septal Defect
VSD is a hole in heart that presents at birth, i.e. child born with a hole in heart. This hole is present between 2 lower chambers of heart, known as right and left ventricles in ventricular septum. This septum separates right and left ventricles.
There are different types of defect noted in ventricular septum:
1. Peri-membranous VSD: most common type
2. Muscular VSD
3. Outlet VSD
4. Sub-pulmonic VSD etc
It depends on size of VSD.
If size of VSD is small, child is generally asymptomatic, and only Systolic murmur will be there on examination by a pediatrician or physician.
If size of VSD is moderate (neither small nor big), child generally have history of poor weight gain, cough and cold etc.
In large sized VSD, child generally presents at 1-2 months of age with complaints of cough, cold, difficulty in breathing, poor weight gain, sweating over forehead.
After confirming the size of VSD and degree of dilatation of left heart chambers on Echocardiography, we can plan further treatment.
If size of VSD is small with no dilatation of left heart chambers then we do follow-up of child at periodic interval. Generally, small VSD closed spontaneously by 4-5 years.
If moderate sized VSD,then it generally associated with left heart dilatation, then we should close the hole between 6 months - 1 year of age.
In large sized VSD: we close between 3-6 months of age.
Medicine is not available for closing the VSD. Medicines are used for controlling symptoms due to heart failure, LRTI etc.
Either angiographically (without surgery) or by surgery.
1. Short hospital stay (2-3 days)
2. No surgical scar on the body
3. Only one tablet once a day for 6 months needs to be taken after the procedure.
4. Can attend school from next day of discharge
5. Can participate in all outdoor activities from very next day
6. Very less risk as compared to surgery, although very safe procedure
7. No requirement of ventilator in most cases
After Device closure by angiographically: After one month then 3, 6, 12 months after the procedure.
After surgery: after 3 days for wound dressing, then 1,3,6,12 months after surgery.
By cardiac angiography from thigh blood vessels that are connected with the heart. We close VSDin a beating heart.
This procedure is generally done under conscious sedation. Within six months, device become endothelized and become a part of heart for life long.