Many babies born with a small ventricular septal defect won't need surgery to close the hole. After birth, your doctor may want to observe your baby and treat symptoms while waiting to see if the defect closes on its own.
Babies who need surgical repair often have the procedure in their first year. Children and adults who have a large ventricular septal defect or one that's causing significant symptoms usually need surgery to close the defect.
Some smaller ventricular septal defects are closed surgically to prevent complications related to their locations, such as damage to heart valves. Many people with small VSDs have productive lives with few related problems.
Babies who have large VSDs or who tire easily during feeding may need extra nutrition to help them grow. Some babies may require tube feeding.
Medications for ventricular septal defect may include those to:
- Increase the strength of the heart's contractions. Examples include digoxin (Lanoxin).
- Decrease the amount of fluid in circulation and in the lungs. Doing so reduces the volume of blood that must be pumped. These medications, called diuretics, include furosemide (Lasix).
- Keep the heartbeat regular. Examples include beta blockers (Lopressor, Inderal LA, others) and digoxin (Lanoxin, Lanoxin Pediatric).
Surgical treatment for ventricular septal defects involves plugging or patching the abnormal opening between the ventricles, using one of these procedures:
- Surgical repair. This procedure of choice in most cases usually involves open-heart surgery under general anesthesia. The surgery requires a heart-lung machine and an incision in the chest. The doctor uses a patch or stitches to close the hole.
- Catheter procedure. Closing a VSD during catheterization doesn't require opening the chest. Rather, 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 specially sized mesh device 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 device closes the VSD via a catheter placed through the incision. Recovery from this procedure is quicker than with standard surgery.
After repair, your doctor will schedule regular medical follow-up to ensure that the VSD remains closed. Depending on the size of the defect and the presence of other problems, your doctor will tell you how frequently you or your child will need to be seen.
If you've been told 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. Current guidelines recommend preventive antibiotic treatment only for 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 recent repair with artificial (prosthetic) material
For most people with a VSD, good oral hygiene and regular dental checkups can prevent endocarditis.
Nov. 04, 2014
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- Ventricular septal defect (adults). American Heart Association. http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Ventricular-Septal-Defect-VSD_UCM_307041_Article.jsp. Accessed Aug. 31, 2014.
- Dummer K, et al. Pathophysiology and clinical features of isolated ventricular septal defects in infants and children. http://www.uptodate.com/home. Accessed Aug. 31, 2014.
- Dummer K, et al. Management of isolated ventricular septal defects in infants and children. http://www.uptodate.com/home. Accessed Aug. 31, 2014.
- Ammash NM, et al. Ventricular septal defect in adults. http://www.uptodate.com/home. Accessed Aug. 31, 2014.
- Congenital heart defects and CCHD. March of Dimes. http://www.marchofdimes.org/baby/congenital-heart-defects.aspx. Accessed Sept. 1, 2014.
- Bonow RO, et al. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed Sept. 15, 2014.
- Konetti NR. Hybrid muscular ventricular defect closure: Surgeon or physician. Indian Heart Journal. 2012;64:568.
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