Materiały źródłowe

• #1 Ventricular septal defect (VSD) | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/ventricular-septal-defect-vsd

  Ventricular septal defect treatment may include regular health checkups, medications and surgery. Many babies born with a small ventricular septal defect (VSD) won’t need surgery to close the hole. Some small VSDs close on their own. […] If the VSD is small, regular health checkups may be all that’s needed. Medication may be prescribed to treat any symptoms. […] Babies who have large VSDs or who tire easily during feeding may need extra nutrition to help them grow. Some babies may require medication to help treat heart failure symptoms. […] Medications won’t repair a ventricular septal defect, but they may be given to treat symptoms or complications. The specific medications used depend on the symptoms and their cause. Water pills (diuretics) are used to decrease the amount of fluid in the body and reduce the strain on the heart.

• #2 Ventricular Septal Defect (VSD): Types & Causes

  https://my.clevelandclinic.org/health/diseases/17615-ventricular-septal-defects-vsd

  A small VSD is usually minor and has few or no symptoms. But a larger hole may need a repair to avoid permanent damage and complications. […] For moderate or large VSDs, your childs provider will likely recommend a VSD procedure or surgery to close the hole. In the meantime, medications can help. […] Repair of a large ventricular septal defect before age 2 can prevent damage to your childs heart and lungs. Without repair before this age, the damage becomes permanent and gets worse over time. […] 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 ventricular septal defect are often the same as those that treat heart failure. […] 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 childs own tissue.

• #3 Ventricular Septal Defect (VSD) | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/ventricular-septal-defect-vsd

  VSD is an opening or hole (defect) in the wall (septum) separating the two lower chambers of the heart (ventricles). […] If the opening is small, it won’t make the heart and lungs work harder. Surgery and other treatments may not be needed. Small VSDs often close on their own. There isn’t any medicine or other treatment that will make the VSD get smaller or close any faster than it might do naturally. […] If an infant is very ill, or has more than one VSD or a VSD in an unusual location, a temporary operation to relieve symptoms and high pressure in the lungs may be needed. […] If the opening is large, open-heart surgery may be needed to close it and prevent serious problems. […] Medicines may be used temporarily to help with symptoms, but they don’t cure the VSD or prevent permanent damage to the lung arteries.

• #4 Treatment of ventricular septal defect in children: Who, when, and how? A 20-years Lebanese multicentric retrospective study

  https://wjarr.com/content/treatment-ventricular-septal-defect-children-who-when-and-how-20-years-lebanese-multicentric

  Ventricular Septal Defect (VSD) is a common congenital heart disease. Three therapeutic approaches exist to treat this anomaly: observation and regular follow-up, surgical closure, and Trans catheter intervention. […] We found that 36.7% of VSDs might totally close over time, particularly if VSD is of muscular type. This rate might also increase with a longer follow-up period.

• #5 Ventricular Septal Defect (VSD) | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/v/vsd

  For most small or moderate-sized ventricular septal defects, observation is needed, with regular checkups with the cardiologist. These are typically more frequent in babies while they are being monitored for development of symptoms, but can be less frequent in older children with small ventricular septal defects, with cardiology visits every few years. […] In babies with large ventricular septal defects, they can be seen as often as weekly to closely watch their growth and decide the timing of surgery. […] Babies who have shown some signs of congestive heart failure will typically be placed on medicine, usually a diuretic or water pill, to help get rid of extra fluid in the lungs. […] When the symptoms of a ventricular septal defect are hard to control with medicines or the baby is unable to grow, surgical closure of the defect is often recommended. Surgical closure of isolated ventricular septal defects is uncomplicated in about 99% of cases.

• #6 Ventricular Septal Defect (VSD) Diagnosis & Treatments | Mount Sinai – New York

  https://www.mountsinai.org/locations/childrens-heart/conditions/ventricular-septal-defect

  When you learn before birth or soon after birth that your child has a ventricular septal defect, also referred to as a VSD, your concern may overwhelm you. We are here to explain the condition, and describe how we can help to ensure your child’s well-being and how to treat the VSD. […] We specialize in the delicate business of treating the smallest heart to heal the VSD and restore your child’s health. And, we can advise you on the best treatment for your child. […] Many small VSDs, and even some medium size VSDs, may get smaller or even close on their own. If that happens, your child may require no treatment. […] If the VSD does not close, your child’s treatment will depend on the size of the VSD, and whether it is causing symptoms. […] To help your baby become big and strong enough for an operation to close the VSD, we may use the following medications: Diuretics—which to make your baby urinate more to help get rid of excess fluid; Digoxin—which makes the heart beat more slowly and stronger.

• #7 Ventricular septal defect (VSD) | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/ventricular-septal-defect-vsd

  Ventricular septal defect treatment may include regular health checkups, medications and surgery. Many babies born with a small ventricular septal defect (VSD) won’t need surgery to close the hole. Some small VSDs close on their own. […] If the VSD is small, regular health checkups may be all that’s needed. Medication may be prescribed to treat any symptoms. […] Babies who have large VSDs or who tire easily during feeding may need extra nutrition to help them grow. Some babies may require medication to help treat heart failure symptoms. […] Medications won’t repair a ventricular septal defect, but they may be given to treat symptoms or complications. The specific medications used depend on the symptoms and their cause. Water pills (diuretics) are used to decrease the amount of fluid in the body and reduce the strain on the heart.

• #8 Ventricular Septal Defects Treatment & Management: Approach Considerations, Medical Management of Symptomatic CHF, Intracardiac Repair of Defect

  https://emedicine.medscape.com/article/892980-treatment

  Children with small ventricular septal defects (VSDs) are asymptomatic and have an excellent long-term prognosis. Neither medical therapy nor surgical therapy is indicated. Prophylactic antibiotic therapy against endocarditis is no longer indicated in most cases. […] In children with moderate or large VSDs, medical therapy is indicated to manage symptomatic congestive heart failure (CHF) because some VSDs may become smaller with time. […] Uncontrolled CHF with growth failure and recurrent respiratory infection is an indication for immediate surgical repair. Neither the age nor the size of the patient is prohibitive in considering surgery. […] Large, asymptomatic defects associated with elevated pulmonary artery (PA) pressure are often repaired when infants are younger than age 6-12 months. Surgical repair is indicated in older asymptomatic children with a normal pulmonary pressure if the pulmonary-to-systemic flow ratio (Qp:Qs) is large enough to result in left ventricular dilatation on echocardiography.

• #9 Ventricular Septal Defects Treatment & Management: Approach Considerations, Medical Management of Symptomatic CHF, Intracardiac Repair of Defect

  https://emedicine.medscape.com/article/892980-treatment

  Therapies used to manage symptomatic congestive heart failure (CHF) in children with moderate or large ventricular septal defects (VSDs) may include the following: Increased caloric density of feedings to ensure adequate weight gain: Occasionally, oral feeds must be supplemented with nasogastric tube feedings, because a baby in CHF may be unable to consume adequate calories for appropriate weight gain. […] Diuretics (eg, furosemide) to relieve pulmonary congestion: Furosemide is usually given in a dosage of 1-3 mg/kg/d divided in 2 or 3 doses; long-term furosemide treatment results in hypercalciuria, renal damage, and electrolyte disturbances. […] Angiotensin-converting enzyme (ACE) inhibitors (eg, captopril and enalapril): These medications reduce both the systemic and pulmonary pressures (the former to a greater degree), thereby reducing the left-to-right shunt.

• #10 Ventricular septal defect (VSD) | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/ventricular-septal-defect-vsd

  Ventricular septal defect treatment may include regular health checkups, medications and surgery. Many babies born with a small ventricular septal defect (VSD) won’t need surgery to close the hole. Some small VSDs close on their own. […] If the VSD is small, regular health checkups may be all that’s needed. Medication may be prescribed to treat any symptoms. […] Babies who have large VSDs or who tire easily during feeding may need extra nutrition to help them grow. Some babies may require medication to help treat heart failure symptoms. […] Medications won’t repair a ventricular septal defect, but they may be given to treat symptoms or complications. The specific medications used depend on the symptoms and their cause. Water pills (diuretics) are used to decrease the amount of fluid in the body and reduce the strain on the heart.

• #11 Muscular Ventricular Septal Defect Treatment & Management: Approach Considerations, Surgical Treatment, Cardiac Catheterization and Hybrid Procedures

  https://emedicine.medscape.com/article/899873-treatment

  Small muscular ventricular septal defects (VSDs) have a high spontaneous closure rate within the first 2 years of life and often require no medical or surgical management. […] Medical therapy may be required with large muscular VSDs due to excessive left-to-right shunting and the development of congestive heart failure (CHF). Therapy is directed at alleviating the symptoms of pulmonary overcirculation and typically includes increased-calorie feedings, diuretics, and, sometimes, an ACE inhibitor. […] Diuretic therapy with furosemide is used to lessen volume overload. Significant potassium wasting may warrant the addition of spironolactone or potassium supplementation. […] The use of afterload reduction to improve systemic-pulmonary flow ratios may be beneficial in selected cases. ACE inhibitors also inhibit the tissue-based renin-angiotensin system, preventing deleterious remodeling. Be aware that ACE inhibitors have a potassium-sparing effect. When these are used, spironolactone or supplemental potassium should be avoided or judiciously used.

• #12 Ventricular Septal Defects Treatment & Management: Approach Considerations, Medical Management of Symptomatic CHF, Intracardiac Repair of Defect

  https://emedicine.medscape.com/article/892980-treatment

  Therapies used to manage symptomatic congestive heart failure (CHF) in children with moderate or large ventricular septal defects (VSDs) may include the following: Increased caloric density of feedings to ensure adequate weight gain: Occasionally, oral feeds must be supplemented with nasogastric tube feedings, because a baby in CHF may be unable to consume adequate calories for appropriate weight gain. […] Diuretics (eg, furosemide) to relieve pulmonary congestion: Furosemide is usually given in a dosage of 1-3 mg/kg/d divided in 2 or 3 doses; long-term furosemide treatment results in hypercalciuria, renal damage, and electrolyte disturbances. […] Angiotensin-converting enzyme (ACE) inhibitors (eg, captopril and enalapril): These medications reduce both the systemic and pulmonary pressures (the former to a greater degree), thereby reducing the left-to-right shunt.

• #13 Ventricular Septal Defect (VSD) – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/ventricular-septal-defect-vsd

  For heart failure, medical therapy (eg, diuretics, digoxin, angiotensin-converting enzyme [ACE] inhibitors) […] Sometimes surgical repair […] Diuretics, digoxin, and ACE inhibitors may be useful to control symptoms of heart failure before cardiac surgery or to temporize in infants with moderate VSDs that seem likely to close spontaneously over time. If infants do not respond to medical treatment or have poor growth, surgical repair is often recommended during the first few months of life. […] Even in asymptomatic children, large VSDs with pulmonary hypertension should be repaired, usually within the first year of life, to prevent later complications, particularly persistent pulmonary hypertension and pulmonary vascular disease leading to Eisenmenger syndrome. […] Children who are healthy without any symptoms or elevated pulmonary artery pressure, but have a persistent shunt large enough to result in left ventricular volume overload, should have their defects closed by 3 to 4 years of age to prevent late complications.

• #14 Ventricular Septal Defects Treatment & Management: Approach Considerations, Medical Management of Symptomatic CHF, Intracardiac Repair of Defect

  https://emedicine.medscape.com/article/892980-treatment

  Therapies used to manage symptomatic congestive heart failure (CHF) in children with moderate or large ventricular septal defects (VSDs) may include the following: Increased caloric density of feedings to ensure adequate weight gain: Occasionally, oral feeds must be supplemented with nasogastric tube feedings, because a baby in CHF may be unable to consume adequate calories for appropriate weight gain. […] Diuretics (eg, furosemide) to relieve pulmonary congestion: Furosemide is usually given in a dosage of 1-3 mg/kg/d divided in 2 or 3 doses; long-term furosemide treatment results in hypercalciuria, renal damage, and electrolyte disturbances. […] Angiotensin-converting enzyme (ACE) inhibitors (eg, captopril and enalapril): These medications reduce both the systemic and pulmonary pressures (the former to a greater degree), thereby reducing the left-to-right shunt.

• #15 Ventricular septal defect – Wikipedia

  https://en.wikipedia.org/wiki/Ventricular_septal_defect

  Most cases do not need treatment and heal during the first years of life. Treatment is either conservative or surgical. Smaller congenital VSDs often close on their own, as the heart grows, and in such cases may be treated conservatively. Some cases may necessitate surgical intervention, i.e. with the following indications: […] For the surgical procedure, a heart-lung machine is required and a median sternotomy is performed. Percutaneous endovascular procedures are less invasive and can be done on a beating heart, but are only suitable for certain patients. Repair of most VSDs is complicated by the fact that the conducting system of the heart is in the immediate vicinity. […] Ventricular septum defect in infants is initially treated medically with cardiac glycosides (e.g., digoxin 10-20 g/kg per day), loop diuretics (e.g., furosemide 1-3 mg/kg per day) and ACE inhibitors (e.g., captopril 0.5-2 mg/kg per day).

• #16 Ventricular Septal Defects Treatment & Management: Approach Considerations, Medical Management of Symptomatic CHF, Intracardiac Repair of Defect

  https://emedicine.medscape.com/article/892980-treatment

  Digoxin (5-10 g/kg/d): This may be indicated if diuresis and afterload reduction do not relieve adequately symptoms, although the data regarding efficacy of this drug in this particular situation are controversial. […] At present, direct surgical repair using cardiopulmonary bypass is the preferred surgical therapy in most centers. […] Most perimembranous and inlet VSDs are repaired via a transatrial surgical approach. […] In a prospective, randomized study of 640 consecutive patients with isolated VSD, Voitov et al found that perventricular device closure (PVDC) and the conventional approach (CA) have similar efficacy for VSD closure. […] Transcatheter therapy remains an experimental approach. […] A murmur of a residual VSD is not infrequent. […] Decisions regarding reoperation are based on symptoms, left heart size, pulmonary pressure, and degree of shunting. […] After intracardiac repair of a VSD, long-term infrequent follow-up is necessary. Patients with small VSDs do not require indefinite follow-up although subacute bacterial endocarditis remains a theoretical risk.

• #17 Ventricular Septal Defect (VSD) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/vsd

  Small VSDs may not cause symptoms and not need treatment. In some cases, they may also close on their own as your child grows. Larger VSDs may need treatment or surgery. […] Treatment options may include: […] Medications: Certain medications can help the heart and reduce symptoms. For example, digoxin can strengthen the heart muscle, so its able to pump more efficiently. Diuretics can help the kidneys remove excess fluid from the body and antibiotics can help prevent bacterial endocarditis (an infection inside the heart). […] Surgery: if the child continues to have symptoms despite medical and nutritional therapy, the defect can be closed with a surgical patch. […] Cardiac catheterization: In rare circumstance, a VSD can be closed, or partially closed, with a device delivered by a catheter.

• #18 Ventricular Septal Defect (VSD) Diagnosis & Treatments | Mount Sinai – New York

  https://www.mountsinai.org/locations/childrens-heart/conditions/ventricular-septal-defect

  When you learn before birth or soon after birth that your child has a ventricular septal defect, also referred to as a VSD, your concern may overwhelm you. We are here to explain the condition, and describe how we can help to ensure your child’s well-being and how to treat the VSD. […] We specialize in the delicate business of treating the smallest heart to heal the VSD and restore your child’s health. And, we can advise you on the best treatment for your child. […] Many small VSDs, and even some medium size VSDs, may get smaller or even close on their own. If that happens, your child may require no treatment. […] If the VSD does not close, your child’s treatment will depend on the size of the VSD, and whether it is causing symptoms. […] To help your baby become big and strong enough for an operation to close the VSD, we may use the following medications: Diuretics—which to make your baby urinate more to help get rid of excess fluid; Digoxin—which makes the heart beat more slowly and stronger.

• #19 Ventricular Septal Defect (VSD) – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/ventricular-septal-defect-vsd

  For heart failure, medical therapy (eg, diuretics, digoxin, angiotensin-converting enzyme [ACE] inhibitors) […] Sometimes surgical repair […] Diuretics, digoxin, and ACE inhibitors may be useful to control symptoms of heart failure before cardiac surgery or to temporize in infants with moderate VSDs that seem likely to close spontaneously over time. If infants do not respond to medical treatment or have poor growth, surgical repair is often recommended during the first few months of life. […] Even in asymptomatic children, large VSDs with pulmonary hypertension should be repaired, usually within the first year of life, to prevent later complications, particularly persistent pulmonary hypertension and pulmonary vascular disease leading to Eisenmenger syndrome. […] Children who are healthy without any symptoms or elevated pulmonary artery pressure, but have a persistent shunt large enough to result in left ventricular volume overload, should have their defects closed by 3 to 4 years of age to prevent late complications.

• #20 Ventricular septal defect (VSD) | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/ventricular-septal-defect-vsd

  Ventricular septal defect treatment may include regular health checkups, medications and surgery. Many babies born with a small ventricular septal defect (VSD) won’t need surgery to close the hole. Some small VSDs close on their own. […] If the VSD is small, regular health checkups may be all that’s needed. Medication may be prescribed to treat any symptoms. […] Babies who have large VSDs or who tire easily during feeding may need extra nutrition to help them grow. Some babies may require medication to help treat heart failure symptoms. […] Medications won’t repair a ventricular septal defect, but they may be given to treat symptoms or complications. The specific medications used depend on the symptoms and their cause. Water pills (diuretics) are used to decrease the amount of fluid in the body and reduce the strain on the heart.

• #21 Ventricular Septal Defects Treatment & Management: Approach Considerations, Medical Management of Symptomatic CHF, Intracardiac Repair of Defect

  https://emedicine.medscape.com/article/892980-treatment

  Therapies used to manage symptomatic congestive heart failure (CHF) in children with moderate or large ventricular septal defects (VSDs) may include the following: Increased caloric density of feedings to ensure adequate weight gain: Occasionally, oral feeds must be supplemented with nasogastric tube feedings, because a baby in CHF may be unable to consume adequate calories for appropriate weight gain. […] Diuretics (eg, furosemide) to relieve pulmonary congestion: Furosemide is usually given in a dosage of 1-3 mg/kg/d divided in 2 or 3 doses; long-term furosemide treatment results in hypercalciuria, renal damage, and electrolyte disturbances. […] Angiotensin-converting enzyme (ACE) inhibitors (eg, captopril and enalapril): These medications reduce both the systemic and pulmonary pressures (the former to a greater degree), thereby reducing the left-to-right shunt.

• #22 About Ventricular Septal Defect | Congenital Heart Defects (CHDs) | CDC

  https://www.cdc.gov/heart-defects/about/ventricular-septal-defect.html

  Treatments for a VSD depend on the size of the hole and the problems it might cause. Many VSDs are small and close on their own. If the hole is small and causing no symptoms, the doctor will check the infant regularly. This is to ensure there are no signs of heart failure and that the hole closes. If the hole doesn’t close on its own or if it’s large, further action might be needed. […] Depending on the child’s general health, symptoms, and the hole’s size, the doctor might recommend cardiac catheterization or open-heart surgery. These procedures will close the hole and restore normal blood flow. After surgery, the doctor will set up regular follow-up visits to make sure that the VSD remains closed. […] Some babies and children will need medicines to help: […] strengthen the heart muscle, […] lower their blood pressure, […] help the body get rid of extra fluid. […] To make sure babies have a healthy weight gain, a special high-calorie formula might be prescribed. Some babies become extremely tired while feeding and might need to be fed through a feeding tube.

• #23 Ventricular septal defect (VSD): Symptoms, types, surgery, and more

  https://www.medicalnewstoday.com/articles/vsd-heart

  A ventricular septal defect (VSD) is a hole in the septum, which is the wall separating the two lower chambers of the heart. […] After confirming a diagnosis of VSD, a doctor will recommend treatment based on the size of the hole and the symptoms. […] Many infants with VSD require no treatment because the hole closes on its own in the majority of cases. […] However, some infants do need treatment, which may involve: feeding support, such as special formula or additional pumped breast milk; medication to lower blood pressure, reduce fluid retention, or strengthen the heart muscle; surgery to close the hole; antibiotics to prevent infections after surgery. […] People with VSD typically receive ongoing care from a cardiologist. After the hole closes, most people will not need additional treatment. […] Even when surgery is necessary, the outcomes are very good, and children typically live a regular, healthy life.

• #24 Ventricular Septal Defect – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470330/

  Ventricular septal defects (VSDs) are the most prevalent congenital cardiac anomaly in children and the second most common heart defect in adults, after bicuspid aortic valves. […] For symptomatic cases or complications, VSD closure may be required. […] Many small VSDs close spontaneously within the first year of life, and asymptomatic cases often require no intervention. […] VSD closure is generally indicated for medium-to-large defects causing significant hemodynamic compromise, especially in symptomatic cases with left ventricular dysfunction. […] Surgical repair of VSDs offers several benefits, including a reduced risk of endocarditis, potential improvement in PAH, and enhanced overall survival. […] Surgical intervention may also be considered for milder shunts (Qp:Qs 1.5) if there is evidence of left ventricular systolic or diastolic dysfunction.

• #25 Ventricular Septal Defects Treatment & Management: Approach Considerations, Medical Management of Symptomatic CHF, Intracardiac Repair of Defect

  https://emedicine.medscape.com/article/892980-treatment

  Children with small ventricular septal defects (VSDs) are asymptomatic and have an excellent long-term prognosis. Neither medical therapy nor surgical therapy is indicated. Prophylactic antibiotic therapy against endocarditis is no longer indicated in most cases. […] In children with moderate or large VSDs, medical therapy is indicated to manage symptomatic congestive heart failure (CHF) because some VSDs may become smaller with time. […] Uncontrolled CHF with growth failure and recurrent respiratory infection is an indication for immediate surgical repair. Neither the age nor the size of the patient is prohibitive in considering surgery. […] Large, asymptomatic defects associated with elevated pulmonary artery (PA) pressure are often repaired when infants are younger than age 6-12 months. Surgical repair is indicated in older asymptomatic children with a normal pulmonary pressure if the pulmonary-to-systemic flow ratio (Qp:Qs) is large enough to result in left ventricular dilatation on echocardiography.

• #26 Diagnosis and Management of Ventricular Septal Defects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11607469/

  This review addresses the diagnosis and management of ventricular septal defects (VSDs). […] Intervention is usually indicated for symptomatic patients with moderate- to large-sized VSDs. Surgical closure is advised for perimembranous, supracristal and inlet VSDs, and for deficits involving prolapsed aortic valve leaflets. […] Early identification and timely closure of the VSD, either through surgical or transcatheter methods, before the age of 18 months, is critical in reducing the prevalence of PVOD. […] For patients with moderate to large VSDs, intervention is necessary. Initial management should focus on addressing CHF, if present, followed by surgical or transcatheter closure, as appropriate. […] The surgical procedure for VSD closure typically begins with the patient under general anesthesia, followed by a mid-sternal incision to open the chest.

• #27 Ventricular Septal Defect (VSD) – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/ventricular-septal-defect-vsd

  For heart failure, medical therapy (eg, diuretics, digoxin, angiotensin-converting enzyme [ACE] inhibitors) […] Sometimes surgical repair […] Diuretics, digoxin, and ACE inhibitors may be useful to control symptoms of heart failure before cardiac surgery or to temporize in infants with moderate VSDs that seem likely to close spontaneously over time. If infants do not respond to medical treatment or have poor growth, surgical repair is often recommended during the first few months of life. […] Even in asymptomatic children, large VSDs with pulmonary hypertension should be repaired, usually within the first year of life, to prevent later complications, particularly persistent pulmonary hypertension and pulmonary vascular disease leading to Eisenmenger syndrome. […] Children who are healthy without any symptoms or elevated pulmonary artery pressure, but have a persistent shunt large enough to result in left ventricular volume overload, should have their defects closed by 3 to 4 years of age to prevent late complications.

• #28 Ventricular Septal Defects Treatment & Management: Approach Considerations, Medical Management of Symptomatic CHF, Intracardiac Repair of Defect

  https://emedicine.medscape.com/article/892980-treatment

  Digoxin (5-10 g/kg/d): This may be indicated if diuresis and afterload reduction do not relieve adequately symptoms, although the data regarding efficacy of this drug in this particular situation are controversial. […] At present, direct surgical repair using cardiopulmonary bypass is the preferred surgical therapy in most centers. […] Most perimembranous and inlet VSDs are repaired via a transatrial surgical approach. […] In a prospective, randomized study of 640 consecutive patients with isolated VSD, Voitov et al found that perventricular device closure (PVDC) and the conventional approach (CA) have similar efficacy for VSD closure. […] Transcatheter therapy remains an experimental approach. […] A murmur of a residual VSD is not infrequent. […] Decisions regarding reoperation are based on symptoms, left heart size, pulmonary pressure, and degree of shunting. […] After intracardiac repair of a VSD, long-term infrequent follow-up is necessary. Patients with small VSDs do not require indefinite follow-up although subacute bacterial endocarditis remains a theoretical risk.

• #29 Diagnosis and Management of Ventricular Septal Defects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11607469/

  This review addresses the diagnosis and management of ventricular septal defects (VSDs). […] Intervention is usually indicated for symptomatic patients with moderate- to large-sized VSDs. Surgical closure is advised for perimembranous, supracristal and inlet VSDs, and for deficits involving prolapsed aortic valve leaflets. […] Early identification and timely closure of the VSD, either through surgical or transcatheter methods, before the age of 18 months, is critical in reducing the prevalence of PVOD. […] For patients with moderate to large VSDs, intervention is necessary. Initial management should focus on addressing CHF, if present, followed by surgical or transcatheter closure, as appropriate. […] The surgical procedure for VSD closure typically begins with the patient under general anesthesia, followed by a mid-sternal incision to open the chest.

• #30 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/Content?contentTypeID=161&ContentID=110

  Ventricular septal defect (VSD) surgery is a type of heart surgery. It’s done to fix a hole between the left and right ventricles of the heart. […] During this surgery, a surgeon makes a cut down the front of the chest and divides the breastbone to reach the heart. A heart-lung machine is used to pump blood and act as the lungs during the surgery. Then the surgeon patches up the hole between the ventricles. Over time, the child’s own cells grow over the patch. This anchors it in place even more. […] Health care providers often advise some type of repair for children who have a large VSD, even if they don’t have symptoms yet. It can prevent long-term damage to the lungs. […] Surgery is still the standard of care. But a minimally invasive procedure using cardiac catheterization may be a choice to fix the VSD for some children. This approach uses a long, flexible tube (catheter) inserted through a blood vessel in the groin instead of open heart surgery.

• #31 Ventricular septal defect – Wikipedia

  https://en.wikipedia.org/wiki/Ventricular_septal_defect

  A device, known as the Amplatzer muscular VSD occluder, may be used to close certain VSDs. It was initially approved in 2009. It appears to work well and be safe. The cost is also lower than having open heart surgery. The device is placed through a small incision in the groin. […] Surgical closure of a Perimembranous VSD is performed on cardiopulmonary bypass with ischemic arrest. Patients are usually cooled to 28 degrees. Percutaneous Device closure of these defects is rarely performed in the United States because of the reported incidence of both early and late onset complete heart block after device closure, presumably secondary to device trauma to the AV node. […] Several patch materials are available, including native pericardium, bovine pericardium, PTFE (Gore-Tex or Impra), or Dacron. […] Intraoperative transesophageal echocardiography is used to confirm secure closure of the VSD, normal function of the aortic and tricuspid valves, good ventricular function, and the elimination of all air from the left side of the heart.

• #32 Ventricular Septal Defect (VSD) Treatment | Types & Symptoms | Max Hospital

  https://www.maxhealthcare.in/our-specialities/paediatric/conditions-treatments/ventricular-septal-defect

  Treatment for a ventricular septal defect (VSD) may include regular medical checkups, medications, or surgery, depending on the size of the defect and its impact on heart function. Many babies born with a small VSD do not require surgical intervention, as the hole may close on its own over time. […] Surgery is recommended for medium or large VSDs that cause significant symptoms or complications. The timing of the procedure depends on the severity of the defect. Babies who need surgery often undergo the procedure within their first year of life. […] After VSD repair, lifelong follow-up care with a cardiologist is essential. Regular checkups, including imaging tests, help monitor heart function and ensure that the repair remains effective over time. […] Medications cannot close a VSD, but they help manage symptoms and complications. The type of medication prescribed depends on the severity of symptoms. […] Some VSDs can be closed without open-heart surgery using a catheter-based approach. A thin, flexible tube (catheter) is inserted into a blood vessel, in the groin, and guided to the heart. A small closure device is then placed over the hole to seal it.

• #33 Muscular Ventricular Septal Defect Treatment & Management: Approach Considerations, Surgical Treatment, Cardiac Catheterization and Hybrid Procedures

  https://emedicine.medscape.com/article/899873-treatment

  Failure of medical management to alleviate symptoms in the first 6 months of life requires intervention. Growth failure despite optimal medical therapy and maximized calorie intake is the most important evidence of failure of medical therapy. Intervention is either by surgery or by cardiac catheterization. Very large left-to-right shunts are usually electively repaired within the first year of life. […] Surgical repair is the most common intervention currently performed. […] Surgical approaches using smaller incisions have proven effective in single ventricular septal defect (VSD) closure. […] Surgical repair of an isolated large VSD involves closure of the muscular defect with a Gore-Tex patch. […] Patients with multiple muscular VSDs may undergo pulmonary artery banding if primary repair is deemed too risky. This palliative procedure limits the degree of left-to-right shunting and allows additional time for these defects to decrease in size or undergo spontaneous closure.

• #34 Ventricular Septal Defect (VSD) – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/ventricular-septal-defect-vsd

  The surgical mortality rate is 2%. Surgical complications may include residual ventricular shunt and/or complete heart block. […] Transcatheter closure of some defects may be possible but is rarely considered a preferable option. […] Endocarditis prophylaxis is not needed preoperatively and is required only for the first 6 months after repair or if there is a residual defect adjacent to a surgical patch.

• #35 Ventricular Septal Defects Treatment & Management: Approach Considerations, Medical Management of Symptomatic CHF, Intracardiac Repair of Defect

  https://emedicine.medscape.com/article/892980-treatment

  Digoxin (5-10 g/kg/d): This may be indicated if diuresis and afterload reduction do not relieve adequately symptoms, although the data regarding efficacy of this drug in this particular situation are controversial. […] At present, direct surgical repair using cardiopulmonary bypass is the preferred surgical therapy in most centers. […] Most perimembranous and inlet VSDs are repaired via a transatrial surgical approach. […] In a prospective, randomized study of 640 consecutive patients with isolated VSD, Voitov et al found that perventricular device closure (PVDC) and the conventional approach (CA) have similar efficacy for VSD closure. […] Transcatheter therapy remains an experimental approach. […] A murmur of a residual VSD is not infrequent. […] Decisions regarding reoperation are based on symptoms, left heart size, pulmonary pressure, and degree of shunting. […] After intracardiac repair of a VSD, long-term infrequent follow-up is necessary. Patients with small VSDs do not require indefinite follow-up although subacute bacterial endocarditis remains a theoretical risk.

• #36 Ventricular Septal Defect (VSD) (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/vsd.html

  VSDs are the most common congenital heart defect. Most VSDs are diagnosed and treated successfully with few or no complications. […] 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 there are no other problems. […] In many kids, a small defect will close on its own without surgery. […] Kids with medium to large VSDs might need prescription medicines to aid circulation and help the heart work better. […] So, the cardiologist may recommend heart surgery to fix the hole. […] Surgery usually is done within the first few weeks to months of a child’s life. […] The surgeon can stitch the hole closed directly or, more commonly, will sew a patch of manmade surgical material over it. […] Rarely, cardiologists may close some types of VSDs with cardiac catheterization. […] After surgery, most kids go on to live healthy, active lives.

• #37 Ventricular Septal Defect Closure: Surgery & Treatment Options – The Kingsley Clinic

  https://thekingsleyclinic.com/resources/ventricular-septal-defect-closure-surgery-treatment-options/

  Choosing a highly qualified surgical team and following pre-operative instructions can help reduce the risks associated with VSD closure surgery. Open communication with your healthcare providers ensures that all necessary precautions are taken to achieve the best possible outcome. […] VSD closure surgery has an excellent success rate, with over 95% of patients achieving complete defect closure. This results in improved symptoms, enhanced heart function, and normalized blood circulation, which reduces strain on the heart and lungs. […] Additional therapies, such as cardiac rehabilitation or long-term medication management, may further optimize heart function after surgery. Medications may include those for regulating heart rhythm, controlling blood pressure, or preventing blood clots. Treatment plans are tailored to each patient’s unique needs.

• #38 Ventricular Septal Defect – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470330/

  Transcatheter closure is increasingly recognized as an effective intervention for various types of VSDs, with specific indications guiding its use based on the defect’s characteristics and the patient’s clinical condition. […] This intervention is typically recommended to prevent the progression of tricuspid regurgitation and the potential development of infective endocarditis. […] In summary, VSD is the most common congenital anomaly identified at birth. While small defects often close spontaneously within the first year of life, larger defects can lead to significant complications. Surgical closure and transcatheter device closure are the primary interventions for managing larger defects effectively.

• #39 Pediatric Ventricular Septal Defect (VSD) – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/ventricular-septal-defect-vsd

  Treatment may include medicine, good nutrition, surgery or cardiac catheterization. […] A small ventricular septal defect may close on its own as your child grows. Some small defects dont close on their own, but they still dont need treatment. A larger VSD often needs to be fixed with surgery or through cardiac catheterization. Once a child is diagnosed with a VSD, their heart doctor will check the defect regularly to see if its closing on its own. […] Some children may need to take medicine to help the heart work better. Children without symptoms may not need medicine. […] The goal of surgery is to close the septal opening before the lungs are damaged. Surgery will also help babies who have trouble feeding gain a normal amount of weight. Your child’s heart doctor will decide when your child should have surgery. This may be based on echocardiogram and cardiac catheterization results. In surgery, your childs doctor will close the ventricular septal defect with stitches or a special patch.

• #40 Pediatric Ventricular Septal Defect (VSD) – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/ventricular-septal-defect-vsd

  VSD may be fixed by a cardiac catheterization. In this test, a tool called a septal occluder is used with a catheter. The doctor guides the catheter through the blood vessels to the heart. Once the catheter is in the heart, the doctor closes defect with the septal occluder. Only certain types of VSDs may be closed with this method. This procedure should be done in centers that have staff with experience in doing transcatheter VSD repair. […] If the VSD is moderate to severe, your childs heart doctor will closely monitor him or her. The doctor will decide when and how your childs ventricular septal defect will be fixed. Before surgery, your child may need medicine and special feedings. […] Most children who have surgery for VSD will live normal, healthy lives. Their activity levels, appetite, and growth often return to normal. Your child’s heart doctor may give him or her antibiotics to prevent infections after leaving the hospital.

• #41 Ventricular Septal Defects: Symptoms, and Treatment | Doctor

  https://patient.info/doctor/ventricular-septal-defect-pro

  Development of aortic valve prolapse and aortic regurgitation in perimembranous VSDs may be an indication for surgical closure. […] Most defects are closed nowadays by directly placing a patch from the right ventricular side, usually with the surgeon working through the tricuspid valve. […] Patients with large muscular VSDs which are difficult to see or those with multiple holes (Swiss cheese septum) presenting as neonates or infants need initial palliation in the form of pulmonary artery banding followed many months later by corrective surgery and removal of the pulmonary artery band. […] Advances in catheter techniques and devices mean that many muscular and perimembranous VSDs can now be closed percutaneously. […] Transcatheter techniques are useful because they avoid cardiopulmonary bypass.

• #42 Ventricular Septal Defects: Symptoms, and Treatment | Doctor

  https://patient.info/doctor/ventricular-septal-defect-pro

  The National Institute for Health and Care Excellence (NICE) has provided detailed guidance on indications, efficacy and complications of the procedure. […] It is safer to close muscular VSDs using a device but muscular VSDs which are haemodynamically significant are likely to be seen in only young infants, making catheterisation difficult and challenging.

• #43 Diagnosis and Management of Ventricular Septal Defects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11607469/

  Surgical methods to address other CHDs, including VSDs, were soon established. […] The majority of VSD occluding devices are double-disc devices, which require substantial septal rims for stable positioning. […] The Amplatzer Muscular VSD Occluder is a specialized device designed for the transcatheter closure of muscular ventricular septal defects. […] Surgical closure of perimembranous, supracristal, and inlet VSDs is generally recommended. […] While transcatheter closure of perimembranous VSDs with Amplatzer Membranous VSD Occluder is technically feasible, it is not endorsed due to concerns regarding the potential for inducing complete heart block, a complication observed in a substantial number of patients. […] In conclusion, while the majority of the treatment alternatives examined have demonstrated adequate results, it is crucial to exercise caution in the management of small defects to avoid unnecessary interventions. Conversely, the prompt and effective closure of large VSDs is critical to prevent the development of pulmonary vascular obstructive disease.

• #44 Pediatric Ventricular Septal Defect (VSD) Closure Devices – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/ventricular-septal-defect-repair-treatment

  Muscular ventricular septal defect (VSD) is a congenital heart condition that can affect blood flow in your child’s heart. […] At Children’s National Heart Center, we use advanced catheterization procedures to close these holes. […] Surgery is not often necessary for small holes. Open-heart surgery is a common treatment for larger holes, but at Children’s National, we have another option. Our expert cardiac catheterization team uses minimally invasive, catheter-based procedures to repair larger holes. This leads to a shorter recovery, less pain and a quicker return to normal activities. In addition, there is no chest scar. […] The AMPLATZER device is the most advanced device of its type available in the United States. Our team has extensive experience using the AMPLATZER Duct Occluder to repair VSD in babies and children.

• #45 Ventricular Septal Defect (VSD) Treatment – CHMT

  https://chmt-la.com/ventricular-septal-defect-vsd-treatment/

  Treatment for Ventricular Septal Defect in Cuba is either through minimally invasive catheter-based techniques or traditional surgery based on the size and location of the defect, the presence of symptoms, and the age and overall health of the patient. […] For larger or symptomatic VSDs, treatment options include minimally invasive catheter-based procedures or traditional open-heart surgery. […] Cardiac catheterization, also known as transcatheter closure, is a non-surgical, minimally invasive method whereby a catheter is inserted into a vein, usually in the groin or arm and then guided to the heart. A specialized closure device is then passed through the catheter and placed over the VSD. Once the device is in position, it expands to seal the defect. With time, heart tissue grows around it, permanently closing the opening.

• #46 Diagnosis and Management of Ventricular Septal Defects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11607469/

  Surgical methods to address other CHDs, including VSDs, were soon established. […] The majority of VSD occluding devices are double-disc devices, which require substantial septal rims for stable positioning. […] The Amplatzer Muscular VSD Occluder is a specialized device designed for the transcatheter closure of muscular ventricular septal defects. […] Surgical closure of perimembranous, supracristal, and inlet VSDs is generally recommended. […] While transcatheter closure of perimembranous VSDs with Amplatzer Membranous VSD Occluder is technically feasible, it is not endorsed due to concerns regarding the potential for inducing complete heart block, a complication observed in a substantial number of patients. […] In conclusion, while the majority of the treatment alternatives examined have demonstrated adequate results, it is crucial to exercise caution in the management of small defects to avoid unnecessary interventions. Conversely, the prompt and effective closure of large VSDs is critical to prevent the development of pulmonary vascular obstructive disease.

• #47 Ventricular Septal Defect Treatment | VSD Closure

  https://www.structuralheart.abbott/patients/treatment/vsd-closure-ventricular-septal-defect

  The procedure itself should last about one to two hours and will take place in a heart catheterization laboratory, where many minimally invasive, non-surgical procedures are performed. […] Because the procedure is minimally invasive, the recovery will likely be quick and easy. Many people are discharged from the hospital within 24 hours. […] If you experience any of following symptoms after the procedure: chest pain, numbness, sudden weakness, dizziness or rapid heartbeat, seek medical help immediately. […] Every person recovers differently, and your doctor can help determine when activities can be resumed. In general all strenuous activity should be avoided for one month after the procedure. […] There are certain potential risks associated with catheter-based procedures as well as additional risks that may be associated with the device.

• #48 Treatment of Ventricular Septal Defect (VSD) | Best Hospitals | Clinics | Prices | Booking Health

  https://bookinghealth.com/disease/ventricular-septal-defect-vsd-14

  The surgical intervention is performed under intravenous anesthesia and puncture access through the femoral artery and femoral vein, through which the catheters and the occluder itself will subsequently be passed. […] The duration of the operation does not exceed 40 minutes. […] Within a day after the operation, there will be adjusted the infusion of anticoagulants, within 3 days, antibiotic therapy is started, and during the next 3-6 months drug therapy is continued.

• #49 Ventricular Septal Defect Treatment | VSD Closure

  https://www.structuralheart.abbott/patients/treatment/vsd-closure-ventricular-septal-defect

  The procedure itself should last about one to two hours and will take place in a heart catheterization laboratory, where many minimally invasive, non-surgical procedures are performed. […] Because the procedure is minimally invasive, the recovery will likely be quick and easy. Many people are discharged from the hospital within 24 hours. […] If you experience any of following symptoms after the procedure: chest pain, numbness, sudden weakness, dizziness or rapid heartbeat, seek medical help immediately. […] Every person recovers differently, and your doctor can help determine when activities can be resumed. In general all strenuous activity should be avoided for one month after the procedure. […] There are certain potential risks associated with catheter-based procedures as well as additional risks that may be associated with the device.

• #50 Pediatric Ventricular Septal Defect | Memorial Hermann

  https://memorialhermann.org/services/conditions/pediatric-ventricular-septal-defect

  In very small children, or when catheter closure is difficult, a hybrid, or collaborative procedure between an interventional cardiologist and a heart surgeon, may take place where a surgery is performed, but the defect is closed with a catheter-based device without the use of a heart-lung bypass machine. The ability to close VSDs with a device is mostly depended on their location in the ventricular septum, and whether the device will affect the heart valves or electrical system. […] The third option for VSD closure involves open heart surgery. Surgery is usually performed through a vertical (up and down) incision in the middle of the chest. Repair does require open heart surgery and the patient is put on the heart-lung bypass machine. The machine oxygenates the blood and then pumps it back into the body. In this way, the surgeon can work inside the heart easily.

• #51 Ventricular Septal Defect (VSD) | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/v/vsd

  If the ventricular septal defect is in the muscle or is partially covered by other heart structures, it may get smaller and cause fewer problems over time. If this happens, the infant may not need surgery and will eventually not need medicines. […] In some patients with multiple ventricular septal defects or other associated heart problems, it is sometimes safer to wait to do a complete repair surgery until the child is bigger. However, if they still have significant symptoms despite medicine, they can undergo a procedure to decrease the amount of blood flow to the lungs. This procedure is called pulmonary artery banding. […] Some ventricular septal defects may be closed using an FDA-approved closure device that is placed using a heart catheter (a small plastic tube through which the device may be delivered). This is done more often in older patients. In infants this requires a limited surgery to be used together with catheter placement of the device.

• #52 Ventricular septal defect (VSD)

  https://www.aboutkidshealth.ca/ventricular-septal-defect-vsd

  Treatment for VSDs depends on the size of the hole and can range from no treatment to open heart surgery. […] Small holes may need no treatment. They often do not cause symptoms and may close on their own. Babies with symptoms caused by a VSD may need medication and increased calories to control symptoms and improve weight gain. […] Children with large VSDs who have congestive heart failure are most likely to require surgery to repair and close the VSD. This is done during open heart surgery by applying a patch over the hole. Sometimes, a closure device can be inserted through cardiac catheterization. […] If there are several holes, the cardiologist may insert a band around the pulmonary artery, in a procedure called pulmonary artery banding. This allows the baby to grow until the child is better prepared for surgery to close the holes.

• #53 Ventricular Septal Defects: Symptoms, and Treatment | Doctor

  https://patient.info/doctor/ventricular-septal-defect-pro

  Development of aortic valve prolapse and aortic regurgitation in perimembranous VSDs may be an indication for surgical closure. […] Most defects are closed nowadays by directly placing a patch from the right ventricular side, usually with the surgeon working through the tricuspid valve. […] Patients with large muscular VSDs which are difficult to see or those with multiple holes (Swiss cheese septum) presenting as neonates or infants need initial palliation in the form of pulmonary artery banding followed many months later by corrective surgery and removal of the pulmonary artery band. […] Advances in catheter techniques and devices mean that many muscular and perimembranous VSDs can now be closed percutaneously. […] Transcatheter techniques are useful because they avoid cardiopulmonary bypass.

• #54 Ventricular Septal Defects Treatment & Management: Approach Considerations, Medical Management of Symptomatic CHF, Intracardiac Repair of Defect

  https://emedicine.medscape.com/article/892980-treatment

  Prolapse of an aortic valve cusp is an indication for surgery even if the VSD is small. Early repair may prevent progression of the aortic valve insufficiency. […] Early surgical repair (younger than age 1 year) of VSD appears to lead to a significant postsurgical acceleration of growth within 3-6 months in term and preterm infants and, thus, a favorable growth pattern. […] VSD closure is recommended regardless of symptoms in patients with evidence of left ventricular (LV) volume overload without pulmonary artery hypertension (PAH) (no noninvasive signs of pulmonary artery pressure [PAP] elevation or invasive proof of pulmonary vascular resistance [PVR] 3 Wood units [WU] in case of such signs). […] VSD closure is not recommended in those with Eisenmenger physiology and those with severe PAH (PVR 5 WU) who present with exercise desaturation.

• #55 Ventricular Septal Defects: Symptoms, and Treatment | Doctor

  https://patient.info/doctor/ventricular-septal-defect-pro

  Development of aortic valve prolapse and aortic regurgitation in perimembranous VSDs may be an indication for surgical closure. […] Most defects are closed nowadays by directly placing a patch from the right ventricular side, usually with the surgeon working through the tricuspid valve. […] Patients with large muscular VSDs which are difficult to see or those with multiple holes (Swiss cheese septum) presenting as neonates or infants need initial palliation in the form of pulmonary artery banding followed many months later by corrective surgery and removal of the pulmonary artery band. […] Advances in catheter techniques and devices mean that many muscular and perimembranous VSDs can now be closed percutaneously. […] Transcatheter techniques are useful because they avoid cardiopulmonary bypass.

• #56 Ventricular Septal Defect (VSD) | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/ventricular-septal-defect-vsd

  Closing a large VSD by open-heart surgery usually is done in infancy or childhood even in patients with few symptoms, to prevent complications later. […] VSD closure is usually performed by sewing a patch of fabric or pericardium (the normal lining around the outside of the heart) over the VSD to close it completely. […] Patients with repaired VSDs and normal pulmonary artery pressures have normal lifespans. […] Usually closure is recommended for small VSDs only if there’s been an episode of endocarditis which is a heart infection that may be due to the VSD, or if the location of the VSD affects the function of one of the heart valves. […] If the VSD is large, the pressure in the lungs determines whether it can be closed in an adult patient. […] People whose ventricular septal defects are repaired rarely need more surgery unless the patch leaks or other holes are discovered later.

• #57 Ventricular Septal Defects Treatment & Management: Approach Considerations, Medical Management of Symptomatic CHF, Intracardiac Repair of Defect

  https://emedicine.medscape.com/article/892980-treatment

  Prolapse of an aortic valve cusp is an indication for surgery even if the VSD is small. Early repair may prevent progression of the aortic valve insufficiency. […] Early surgical repair (younger than age 1 year) of VSD appears to lead to a significant postsurgical acceleration of growth within 3-6 months in term and preterm infants and, thus, a favorable growth pattern. […] VSD closure is recommended regardless of symptoms in patients with evidence of left ventricular (LV) volume overload without pulmonary artery hypertension (PAH) (no noninvasive signs of pulmonary artery pressure [PAP] elevation or invasive proof of pulmonary vascular resistance [PVR] 3 Wood units [WU] in case of such signs). […] VSD closure is not recommended in those with Eisenmenger physiology and those with severe PAH (PVR 5 WU) who present with exercise desaturation.

• #58 Ventricular Septal Defects Treatment & Management: Approach Considerations, Medical Management of Symptomatic CHF, Intracardiac Repair of Defect

  https://emedicine.medscape.com/article/892980-treatment

  Prolapse of an aortic valve cusp is an indication for surgery even if the VSD is small. Early repair may prevent progression of the aortic valve insufficiency. […] Early surgical repair (younger than age 1 year) of VSD appears to lead to a significant postsurgical acceleration of growth within 3-6 months in term and preterm infants and, thus, a favorable growth pattern. […] VSD closure is recommended regardless of symptoms in patients with evidence of left ventricular (LV) volume overload without pulmonary artery hypertension (PAH) (no noninvasive signs of pulmonary artery pressure [PAP] elevation or invasive proof of pulmonary vascular resistance [PVR] 3 Wood units [WU] in case of such signs). […] VSD closure is not recommended in those with Eisenmenger physiology and those with severe PAH (PVR 5 WU) who present with exercise desaturation.

• #59 Ventricular septal defect (VSD) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ventricular-septal-defect/symptoms-causes/syc-20353495

  A small ventricular septal defect may cause no problems. Many small ventricular septal defects (VSDs) close on their own. Babies with medium or larger VSDs may need surgery early in life to prevent complications. […] Treatment can help prevent many complications. […] Without treatment, heart failure can develop. […] An unrepaired hole in the heart can lead to this complication after many years. […] If you have a VSD and are planning to become pregnant, schedule a visit with your health care provider and follow these steps: […] If you have a family history of heart problems present at birth, consider talking with a genetic counselor and a heart doctor (cardiologist) before getting pregnant.

• #60 Ventricular Septal Defect (VSD): Types & Causes

  https://my.clevelandclinic.org/health/diseases/17615-ventricular-septal-defects-vsd

  Recovery from repair of a VSD depends on the method a provider uses. Transcatheter procedures have shorter recovery times of days or weeks. Surgeries have longer recovery times, like weeks or months. Symptoms of a VSD usually decrease or disappear after surgery or transcatheter repairs. […] In cases of a moderate or large VSD, repair of the hole is usually enough to prevent complications. […] Most people with a VSD have the same life expectancy as someone who doesnt have a VSD. This is very likely if the ventricular septal defect is small and closes on its own. […] If your child has symptoms from a VSD, their healthcare provider will likely advise that they rest and avoid too much physical activity. This includes any activity that puts too much strain on their heart, especially if they have Eisenmenger syndrome. […] If your baby needs treatment for a ventricular septal defect, Cleveland Clinic Childrens is here for you.

• #61 Ventricular septal defect (VSD) | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/ventricular-septal-defect-vsd

  Surgery may be done if the VSD is medium or large or if it’s causing severe symptoms. Babies who need surgery to repair the hole often have the procedure in their first year. […] A surgeon may close small ventricular septal defects if their location in the heart could cause damage to nearby structures, such as the heart valves. […] Surgeries and procedures to repair a ventricular septal defect include: Open-heart surgery. This is the preferred procedure for repairing most ventricular septal defects. A surgeon uses a patch or stitches to close the hole between the lower heart chambers. This type of VSD surgery requires a heart-lung machine and an incision in the chest. […] Catheter procedure. Some ventricular septal defects can be repaired using thin, flexible tubes (catheters) without the need for open-heart surgery. The health care provider inserts a catheter into a blood vessel, usually in the groin, and guides it to the heart. A small device is inserted through the catheter to close the hole. […] After ventricular septal defect surgery, regular checkups are needed for life, ideally by a heart doctor (cardiologist). Checkups often include imaging tests to determine how well surgery is working.

• #62 Ventricular Septal Defect (VSD) | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/ventricular-septal-defect-vsd

  Closing a large VSD by open-heart surgery usually is done in infancy or childhood even in patients with few symptoms, to prevent complications later. […] VSD closure is usually performed by sewing a patch of fabric or pericardium (the normal lining around the outside of the heart) over the VSD to close it completely. […] Patients with repaired VSDs and normal pulmonary artery pressures have normal lifespans. […] Usually closure is recommended for small VSDs only if there’s been an episode of endocarditis which is a heart infection that may be due to the VSD, or if the location of the VSD affects the function of one of the heart valves. […] If the VSD is large, the pressure in the lungs determines whether it can be closed in an adult patient. […] People whose ventricular septal defects are repaired rarely need more surgery unless the patch leaks or other holes are discovered later.

• #63 Pediatric Ventricular Septal Defect (VSD) – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/ventricular-septal-defect-vsd

  VSD may be fixed by a cardiac catheterization. In this test, a tool called a septal occluder is used with a catheter. The doctor guides the catheter through the blood vessels to the heart. Once the catheter is in the heart, the doctor closes defect with the septal occluder. Only certain types of VSDs may be closed with this method. This procedure should be done in centers that have staff with experience in doing transcatheter VSD repair. […] If the VSD is moderate to severe, your childs heart doctor will closely monitor him or her. The doctor will decide when and how your childs ventricular septal defect will be fixed. Before surgery, your child may need medicine and special feedings. […] Most children who have surgery for VSD will live normal, healthy lives. Their activity levels, appetite, and growth often return to normal. Your child’s heart doctor may give him or her antibiotics to prevent infections after leaving the hospital.

• #64 Ventricular Septal Defect (VSD) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/vsd

  Small VSDs may not cause symptoms and not need treatment. In some cases, they may also close on their own as your child grows. Larger VSDs may need treatment or surgery. […] Treatment options may include: […] Medications: Certain medications can help the heart and reduce symptoms. For example, digoxin can strengthen the heart muscle, so its able to pump more efficiently. Diuretics can help the kidneys remove excess fluid from the body and antibiotics can help prevent bacterial endocarditis (an infection inside the heart). […] Surgery: if the child continues to have symptoms despite medical and nutritional therapy, the defect can be closed with a surgical patch. […] Cardiac catheterization: In rare circumstance, a VSD can be closed, or partially closed, with a device delivered by a catheter.

• #65 Ventricular Septal Defect (VSD) – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/ventricular-septal-defect-vsd

  The surgical mortality rate is 2%. Surgical complications may include residual ventricular shunt and/or complete heart block. […] Transcatheter closure of some defects may be possible but is rarely considered a preferable option. […] Endocarditis prophylaxis is not needed preoperatively and is required only for the first 6 months after repair or if there is a residual defect adjacent to a surgical patch.

• #66 Ventricular Septal Defect Closure: Surgery & Treatment Options – The Kingsley Clinic

  https://thekingsleyclinic.com/resources/ventricular-septal-defect-closure-surgery-treatment-options/

  Choosing a highly qualified surgical team and following pre-operative instructions can help reduce the risks associated with VSD closure surgery. Open communication with your healthcare providers ensures that all necessary precautions are taken to achieve the best possible outcome. […] VSD closure surgery has an excellent success rate, with over 95% of patients achieving complete defect closure. This results in improved symptoms, enhanced heart function, and normalized blood circulation, which reduces strain on the heart and lungs. […] Additional therapies, such as cardiac rehabilitation or long-term medication management, may further optimize heart function after surgery. Medications may include those for regulating heart rhythm, controlling blood pressure, or preventing blood clots. Treatment plans are tailored to each patient’s unique needs.

• #67 Diagnosis and Management of Ventricular Septal Defects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11607469/

  Surgical methods to address other CHDs, including VSDs, were soon established. […] The majority of VSD occluding devices are double-disc devices, which require substantial septal rims for stable positioning. […] The Amplatzer Muscular VSD Occluder is a specialized device designed for the transcatheter closure of muscular ventricular septal defects. […] Surgical closure of perimembranous, supracristal, and inlet VSDs is generally recommended. […] While transcatheter closure of perimembranous VSDs with Amplatzer Membranous VSD Occluder is technically feasible, it is not endorsed due to concerns regarding the potential for inducing complete heart block, a complication observed in a substantial number of patients. […] In conclusion, while the majority of the treatment alternatives examined have demonstrated adequate results, it is crucial to exercise caution in the management of small defects to avoid unnecessary interventions. Conversely, the prompt and effective closure of large VSDs is critical to prevent the development of pulmonary vascular obstructive disease.

• #68 Diagnosis and Management of Ventricular Septal Defects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11607469/

  This review addresses the diagnosis and management of ventricular septal defects (VSDs). […] Intervention is usually indicated for symptomatic patients with moderate- to large-sized VSDs. Surgical closure is advised for perimembranous, supracristal and inlet VSDs, and for deficits involving prolapsed aortic valve leaflets. […] Early identification and timely closure of the VSD, either through surgical or transcatheter methods, before the age of 18 months, is critical in reducing the prevalence of PVOD. […] For patients with moderate to large VSDs, intervention is necessary. Initial management should focus on addressing CHF, if present, followed by surgical or transcatheter closure, as appropriate. […] The surgical procedure for VSD closure typically begins with the patient under general anesthesia, followed by a mid-sternal incision to open the chest.

• #69 Ventricular Septal Defect (VSD) Diagnosis & Treatments | Mount Sinai – New York

  https://www.mountsinai.org/locations/childrens-heart/conditions/ventricular-septal-defect

  With large VSDs, we generally recommend closure during the first year of life, to prevent abnormal changes in the small arteries in the lungs. The more significant your child’s symptoms, the earlier we will want to close the VSD. This is most often done through open heart surgery. […] Procedures we use to close your child’s VSD include: Surgery—a pediatric cardiac surgeon operates to repair the VSD by either: Placing a patch or using stitches to close the hole during open-heart surgery; Placing a band around the pulmonary artery. […] In some select cases, catheterization for closure may be an option. […] Once your child’s VSD is repaired successfully, we recommend regularly checking in with one of our cardiologists periodically over the course of your child’s life.

• #70 Treatment of Ventricular Septal Defect (VSD) | Best Hospitals | Clinics | Prices | Booking Health

  https://bookinghealth.com/disease/ventricular-septal-defect-vsd-14

  General indications for surgical treatment include ineffective therapy with medicines to manage symptoms, significant arteriovenous obstruction, and delayed physical development detected in the circulatory system. […] Surgical treatment generally implies suturing or patch filling. […] As a result of surgical treatment, the patient’s condition improves. […] Thus, clinical manifestation, including dyspnea and palpitations, disappear and heart size goes back to normal. […] Unfortunately, in order to allow endovascular closure of the heart defect its diameter should not exceed 22 mm for muscular defects and 18 for membranous defects, and patients should not have more pronounced aortic valve insufficiency and chord attachment of atrioventricular valves to the defect edges. […] To close the defect, special occluders made of nickel-platinum alloy and filled inside are used.

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