What Problems Can Happen?
People with a VSD are at greater risk for developing endocarditis,
an infection of the inner surface of the heart caused by bacteria in the bloodstream.
Bacteria are always in
our mouths, and small amounts get into the bloodstream when we chew and brush our
teeth.
The best way to protect the heart from endocarditis is to reduce oral bacteria
by brushing and flossing daily, and visiting the dentist regularly. In general, it's
not recommended that patients with simple VSDs take antibiotics before dental visits,
except for the first 6 months after surgery.
How Are Ventricular Septal Defects Diagnosed?
VSDs are usually found in the first few weeks of life by a doctor during a routine
checkup. The doctor will hear a heart murmur as blood passes between the left and
right ventricles. A murmur from a VSD has certain features that let a doctor know
that's it's not due to other causes.
If your child has a heart murmur, your doctor may refer you to a pediatric
cardiologist, a doctor who specializes in diagnosing and treating childhood
heart conditions.
The cardiologist will do an exam and take your child's medical history. If a VSD
is suspected, the cardiologist may order one or more of these tests:
- a chest X-ray:
a picture of the heart and surrounding organs
- an electrocardiogram (EKG):
a record of the heart's electrical activity. This is often the primary tool used to
diagnose a VSD.
- a cardiac catheterization: this provides information about the heart's structures
and the blood pressure and blood oxygen levels in its chambers. This test usually
is done for a VSD only when more information is needed than the other tests can give.
(It's sometimes also used to close certain kinds of VSDs.)
How Are Ventricular Septal Defects Treated?
Treatment depends on a child's age and the size, location, and severity of the
VSD. A child with a small defect that causes no symptoms may only need to visit a
cardiologist regularly to make sure that there are no other problems.
In most kids, a small defect will close on its own without surgery. Some might
not close, but they won't get any larger. Kids with small VSDs usually don't need
to restrict their activities.
Kids with medium to large VSDs likely will take prescription medicines to aid circulation
and help the heart work more efficiently. Medicines alone, however, will not close
the VSD, and in these cases, the cardiologist will recommend fixing the hole, either
with cardiac catheterization or heart surgery.
Heart Surgery
Surgery usually is done within the first few weeks to months of a child's life.
The surgeon makes an incision in the chest wall and a heart-lung machine will maintain
circulation while the surgeon closes the hole. The surgeon can stitch the hole closed
directly or, more commonly, will sew a patch of manmade surgical material over it.
Eventually, the tissue of the heart heals over the patch or stitches, and by 6 months
after the surgery, the hole will be completely covered with tissue.
Some kids with VSDs may take heart medicine before surgery to help ease symptoms
from the defect. Those who have surgery for larger VSDs usually leave the hospital
within 4 to 5 days after surgery if there are no problems.
Cardiac Catheterization
Certain types of VSDs may be closed by cardiac
catheterization. A thin, flexible tube (a catheter) is inserted into a blood vessel
in the leg that leads to the heart. The cardiologist guides the tube into the heart
to make measurements of blood flow, pressure, and oxygen levels in the heart chambers.
A special implant, shaped into two disks formed of flexible wire mesh, is positioned
into the hole in the septum. The device is designed to flatten against the septum
on both sides to close and permanently seal the VSD.
After healing from an operation to repair the defect, a child should have no further
symptoms or problems.
What Else Should I Know?
In most cases, kids who have VSD surgery recover quickly and without complications.
But doctors will closely watch the child for signs or symptoms of any problems. Your
child may have another echocardiogram to make sure that the heart defect has closed
completely.
If your child is having trouble breathing, call your doctor or go to the emergency
department immediately. Other symptoms that may indicate a problem include:
- a bluish color around the mouth or on the lips and tongue
- poor appetite or difficulty feeding
- failure to gain weight or weight loss
- listlessness or decreased activity level
- a long-lasting or unexplained fever
- increasing pain, tenderness, or pus oozing from the incision
Call your doctor if you notice any of these signs in your child after closure of
the VSD.
Having your child diagnosed with a heart condition can be scary. But the good news
is that your pediatric cardiologist will be very familiar with VSDs and how best to
manage the condition. Most kids who've had a VSD corrected go on to live healthy,
active lives.
Date reviewed: September 2016