Patient
Information
Ventricular Septal Defects
A ventricular septal defect (VSD)
is a hole between the two pumping chambers of the heart. The
result of such a hole is that some of the blood returning from the
lungs, which should be pumped to the body, is instead pumped back
to the lungs. The effects of a VSD depend quite a lot on the type
of VSD, how large the hole is, and whether there are any other
problems with the heart.
If a hole is large enough, it can
cause shortness of breath and poor growth in childhood, and over
time it can result in permanent injury to the lungs (pulmonary
vascular occlusive disease). Doctors may use medications and
high-calorie formula to help children cope with these problems in
infancy, but most large VSDs require surgical repair (or, rarely,
repair using a catheter device without surgery) within the first
year or two of life.
If the hole is small and there are
no other significant heart problems, it is usually unnecessary to
do anything about a VSD. One exception is the supracristal type
of VSD (discussed below).
With or without surgery, the
prognosis for a VSD is quite good. I believe that most children
with common types of VSDs who have no other heart problems and are
diagnosed and treated appropriately can expect to live normal
lives.
There are a number of differently
types of VSDs:
The most common type of VSD in
babies is the "muscular VSD". The vast majority of these
holes are very small and do not significantly effect the
functioning of the heart. About 90% close up by themselves over
the first year of life, and many close thereafter.
The next most common type of VSD is
the "perimembranous VSD" or "membranous VSD"
(they mean the same thing). This type of VSD can be small or
large. Probably about half of perimembranous VSDs close by
themselves over time or are too small to require repair. Even
large perimembranous VSDs can close over time, but most large
defects wind up requiring surgical repair. Small perimembranous
VSDs may not ever require surgical repair, but a small fraction of
children with this type of VSD may develop some narrowing under
one or both of the valves leading out of the heart (double chamber
right ventricle or sub-aortic stenosis), so even children with
small VSDs, or VSDs that have already closed on their own, need to
be evaluated from time to time.
The third type of VSD is the "supracristal
VSD" or "intraconal VSD" (they mean the same
thing). This type of VSD is very common in children of Asian
descent. Again, it can be small or large, but very often even the
small holes must be surgical repaired because one of the valves of
the heart can be seriously damaged by this type of VSD over time
(aortic valve prolapse).
There are several other types of
VSD, but they are generally associated with multiple other heart
abnormalities. Examples include an inlet VSD (generally part of an
atrioventricular canal defect), anterior malalignment VSD
(generally part of tetralogy of Fallot) and a posterior
malalignment VSD (generally associated with coarctation or
interruption of the aorta and aortic valve abnormalities).
For more information about VSDs,
try some of the web links below. I cannot vouch for the contents,
but with the Internet it's always a case of "browser
beware".
American Heart Association -
http://216.185.112.5/presenter.jhtml?identifier=1306
A good site to see a brief description of the different types
of heart disease and the treatments available
Boston Children's Hospital -
http://web1.tch.harvard.edu/cfapps/A2ZtopicDisplay.cfm?Topic=Ventricular%20Septal%20Defect
Overview of ventricular septal defects
PediHeart -
http://www.pediheart.org/
Includes a "Parent's
Place" with information resources.
March of Dimes -
http://www.modimes.org/HealthLibrary2/FactSheets/Congenital_heart_defects.htm
The Congenital Heart Disease
Resource Page -
http://www.csun.edu/~hcmth011/heart/
This site is maintained by Sheri Berger, and is a good source
of many links, including the congenital heart disease "link
ring" (a series of sites on a common topic).
The Children's Heart Society
-
http://www.childrensheart.org/
Specializes in support for
families and information.
Hendrick Health -
http://www.hendrickhealth.org/healthy/00070160.html
Health Square -
http://www.healthsquare.com/mc/fgmc0113.htm
Congenital Heart Disease Online
Handbook
This web page contains a list of Congenital Heart Diseases. Each
CHD has the medically accepted abbreviation as well as a short
description and a link to detailed definitions of the disease.
Some of the CHD's listed have a link to a diagram that graphically
shows the disease or defect. There is also a section on surgeries
used to correct some of the CHD's listed at this web site, and a
section on medications used to treat CHD's.
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