Ventricular Septal Defect (VSD)
Ventricular septal defect (VSD) means there is a hole in the heart.
The hole occurs in the wall (septum) that separates the heart’s lower chambers (ventricles) and allows blood to pass from the left to the right side of the heart. The oxygen-rich blood then gets pumped back to the lungs instead of out to the body.
A VSD happens during pregnancy if the wall that forms between the two ventricles does not fully develop, leaving a hole.
In a baby with a VSD, blood often flows from the left ventricle through the VSD to the right ventricle and into the lungs. This extra blood being pumped into the lungs forces the heart and lungs to work harder.
VSD is the most common type of congenital heart defect.
Over time, if not repaired, this defect can increase the risk for other complications, including heart failure, high blood pressure in the lungs (called pulmonary hypertension), irregular heart rhythms (called arrhythmia), or stroke.
Types of VSD:
There are four main types of ventricular septal defects. These are:
Membranous: This is the most common type of VSD. These VSDs happen in the upper section of the wall between your ventricles.
Muscular: These happen in the lower part of the wall. With this type, there’s often more than one hole.
Inlet: This is a hole just below the tricuspid valve in your right ventricle and the mitral valve in your left ventricle. When blood enters your ventricles, it must pass a VSD that connects them.
Outlet: This kind of VSD creates a hole just before the pulmonary valve in your right ventricle and just before the aortic valve in your left ventricle. Blood has to go by the VSD on its way through both valves.
What are the symptoms of VSD?
Ventricular septal defect symptoms in a newborn may include:
- Shortness of breath, including fast breathing or struggling to breathe
- Sweatiness or fatigue during feeding
- Growth faltering (slow weight gain)
- Frequent respiratory infections
In older children and adults, a VSD may make them feel tired or out of breath during physical activity.
In most people with VSD, the hole is too small to cause symptoms. However, when the hole is large enough – or if there are multiple holes – blood can leak between the two heart chambers.
What treatment options are there?
Most VSDs are too small to cause issues. In such a case, the child will be monitored to see if symptoms emerge, or if the defect closes by itself.
For moderate or large VSD, your cardiology team may recommend a procedure or surgery to close the hole. Medications may also help.
In the case of a large VSD, repair before the age of 2 can prevent permanent damage to the heart or lungs.
Medications
Medication can treat symptoms of a VSD before surgery or if the VSD is likely to close on its own over time. Common medications for VSD may lessen fluid buildup around your child’s heart, or help control the strength and timing of your child’s heartbeats.
Surgery or procedures
The two main ways to repair a ventricular septal defect are:
Surgery: A cardiac surgeon will patch or close a VSD. They may stitch the hole shut or add a patch made of synthetic material or your child’s own tissue.
Transcatheter procedures: These procedures use a catheter to reach the heart through a major artery. The catheter can plug the hole with a device made from synthetic material.
