Many babies born with a small ventricular septal defect won't ever need to have the defect surgically closed. After birth, your doctor may want to observe your baby and treat any symptoms while waiting to see if the defect will close on its own.
Children and adults who have a ventricular septal defect that is large or is causing significant symptoms usually need surgery to close the defect. If your baby has a ventricular septal defect that needs surgical repair, the procedure will likely be scheduled in your baby's first year of life.
Medications for ventricular septal defect may include those to:
- Keep the heartbeat regular. Examples include beta blockers (Lopressor, Inderal, others) and digoxin (Lanoxin, Lanoxicaps, Lanoxin Pediatric).
- Increase the strength of the heart's contractions. Examples include digoxin (Lanoxin).
- Decrease the amount of fluid in circulation. Doing so reduces the volume of blood that must be pumped. These medications, called diuretics, include furosemide (Lasix).
Surgical treatment for ventricular septal defects involves plugging or patching the abnormal opening between the ventricles. Two approaches are used:
- Surgical repair. This is the procedure of choice in most cases. Surgical repair of a ventricular septal defect usually involves open-heart surgery, which is done under general anesthesia. The surgery requires a heart-lung machine and an incision in the chest. The doctor uses patches or stitches to close the hole.
- Catheter procedure. This method may be used to close some ventricular septal defects. Patching during catheterization doesn't require opening the chest. Rather than opening the chest, the doctor inserts a thin tube (catheter) into a blood vessel in the groin and guides it to the heart. The doctor then uses a small mesh patch or plug to close the hole.
- Hybrid procedure. A hybrid procedure uses surgical and catheter-based techniques. Access to the heart is usually through a small incision and the procedure may be performed without stopping the heart and using the heart-lung machine. A plug is delivered to close the VSD via a catheter placed through the small hole that the surgeon created. Recovery from this procedure is quicker than with standard surgery.
After repair, your doctor will schedule regular medical follow-up to ensure that the ventricular septal defect remains closed. Depending on the size of the ventricular septal defect and the presence or absence of any other problems, your doctor will tell you how frequently you or your child will need to be seen.
Surgery to close a ventricular septal defect generally has excellent long-term results.
If you've been told in the past that you or your child needs to take antibiotics before dental or medical procedures to reduce the risk of infective endocarditis, talk with your doctor. Endocarditis is much more likely to occur from exposure to random germs than from a typical dental exam or surgery. Current guidelines recommend preventive antibiotic treatment only for those people at highest risk of serious complications from infective endocarditis.
Your doctor may still recommend preventive antibiotics if you:
- Have other heart conditions or artificial valves
- Have a large ventricular septal defect that's causing a low blood oxygen level
- Have had a repair with artificial (prosthetic) material
For most people with a ventricular septal defect, practicing good oral hygiene and getting regular dental checkups is the most effective strategy for preventing endocarditis.
Oct. 26, 2011
- Holes in the heart. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/holes/holes_all.html. Accessed Aug. 2, 2011.
- More information for parents of children with VSD. American Heart Association. http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Ventricular-Septal-Defect-VSD_UCM_307041_Article.jsp. Accessed Aug. 3, 2011.
- More information for adults with VSD. American Heart Association. http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Ventricular-Septal-Defect-VSD_UCM_307041_Article.jsp. Accessed Aug. 3, 2011.
- Dummer KB, et al. Pathophysiology and clinical features of isolated ventricular septal defects in infants and children. http://www.uptodate.com/home/index.html. Accessed Aug. 2, 2011.
- Cohen S, et al. Ventricular septal defect. In: Ferri FF. Ferri's Clinical Advisor 2012. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05611-3..C2009-0-38601-8&isbn=978-0-323-05611-3&uniqId=270492172-3#4-u1.0-B978-0-323-05611-3..C2009-0-38601-8--TOP. Accessed Aug. 2, 2011.
- Dummer KB, et al. Management of isolated ventricular septal defects in infants and children. http://www.uptodate.com/home/index.html. Accessed Aug. 2, 2011.
- Nishimura RA. ACC/AHA guideline update on valvular heart disease: Focused update on infective endocarditis. Circulation. 2008;118:887.
- Genetic counseling. American Heart Association. http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/UnderstandYourRiskforCongenitalHeartDefects/Genetic-Counseling_UCM_307393_Article.jsp. Accessed Aug. 3, 2011.
- Ammash NM, et al. Ventricular septal defect in adults. http://www.uptodate.com/home/index.html. Accessed Aug. 2, 2011.
- Cetta F (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 19, 2011.
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