Ventricular Septal Defect
Ventricular Septal Defect is an opening (hole) in the wall between the two ventricles of the heart. Through this opening, some of the clean blood from the left side of the heart passes to the right side. The severity of the patient's complaints and the type of treatment (medication or surgery) largely depend on the size of the opening, ie the amount of blood passing through it.
How is Ventricular Septal Defect (VSD) Diagnosed ?
Small Ventricular Septal Defect is usually diagnosed incidentally when a doctor is visited for any reason such as fever or cough, when a murmur is heard during the examination.
The definitive diagnosis is made by examination and echocardiography performed by a pediatric cardiologist. Since the amount of blood passing through the defect will be greater in medium-sized or large VSDs, it causes increased pressure in the pulmonary arteries and frequent lung disease, on the other hand, the increased blood flow causes the heart to work harder, thus causing more fatigue and enlargement.
In medium-width VSDs, there may be findings such as rapid breathing, excessive sweating and fatigue, especially when sucking, and inability to gain sufficient weight, usually in infancy or a few weeks after birth in large defects. The diagnosis is made by hearing a murmur during the examination and identifying the signs of heart failure.
Pulmonary diseases such as pneumonia and bronchitis are also common in these patients. Since in our country, children are only taken to the doctor when they are sick, other findings and a murmur are difficult to notice in a seriously ill and crying baby. Findings of lung diseases may overshadow cardiac findings. Although some of these patients partially improve with lung infection treatments, they become sick again and again and the definitive diagnosis may therefore be delayed.
For early diagnosis, it is essential to gain the habit of taking healthy children to doctor control in our country. Definitive diagnosis is made by examination and echocardiography performed by a pediatric cardiologist.
How is Ventricular Septal Defect (VSD) Treated ?
Small defects usually do not require treatment. However, some procedures such as circumcision, tooth extraction, dental filling, and surgery require preventive treatment against endocarditis (inflammation of the inner layer of the heart).
In medium-sized and large VSDs, the effects of increased pulmonary blood flow and signs of heart failure can be reduced, and with supportive drug therapy to regulate the heart's work, it is checked whether the gap gets smaller as the child grows. In patients with no improvement, this opening should be closed surgically.
The appropriate time for surgical treatment in VSDs that do not close or shrink on their own is usually around 1-2 years of age.
The opening is closed with a patch, preventing the passage of blood. In recent years, non-surgical closure of medium-sized VSDs with the appropriate position and diameter by the catheter method, just like ASDs, has come to the fore. Although not as common as ASD, there is an option to close some of these defects with this method.
What Should Be Done Prospectively İn a Patient With Ventricular Septal Defect (VSD) ?
Although the probability of spontaneous closure of the opening varies according to the location, size and nature of the defect, it is as high as 70-80%. However, some openings may cause other problems (such as anatomical and functional disorders in the valves) while closing. Therefore, the patient should be under control at regular intervals.
Patients who are small or shrunk in time but not fully closed and who do not require surgical treatment, need preventive treatment against endocarditis (inflammation of the inner layer of the heart) before some procedures such as surgery, circumcision, tooth extraction, tooth filling. This is also valid for patients who have undergone surgery for the first 6 months after surgery.