Ventricular Septal Defect (VSD)

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A ventricular septal defect (VSD) is a hole in the heart tissue separating the two lower chambers (known as the right and left ventricles) and is one of the most common congenital birth defects. A large VSD causes volume overload of the heart by forcing the heart to pump more than twice the normal amount of blood due to recirculation of blood returning from the lungs to the heart through the lungs again.

Treatment of VSD
Treatment and management of a VSD depends on the size and specifics of the defect.

Small VSD: Small defects often close spontaneously during childhood and may require no treatment, however, regular monitoring by a cardiologist will ensure that the abnormal flow does not cause problems for the heart or valves.
Large VSD: Most large VSDs must be repaired in childhood due to severe symptoms, and repair can occur via open surgery or catheter-based treatment depending on the size and location of the defect. Defects repaired in childhood may have mild leak despite the repair, which can often be monitored without therapy. If the leak is significant, it may be treatable with a catheter-based technique.

Eisenmenger Syndrome: Patients with a large unrepaired VSD may develop Eisenmenger Syndrome in adulthood due to the complicated blood flow through the heart and lungs that has developed in adaptation to an unrepaired large VSD. These patients require careful regular monitoring and treatment by adult congenital cardiology specialists.

Post-Infarction VSD: While most VSDs are present at birth, very rarely a heart attack in older adults can cause a tear in the heart tissue, resulting in a VSD. This type of VSD is known specifically as a post-infarction ventricular septal rupture. These patients are often critically ill, requiring emergency care at specialized centers like Houston Methodist.

Other conditions: VSDs are often associated with other congenital heart defects, and their management may depend on the condition of the other problems. Patients with these conditions should be seen at an adult congenital heart specialty center like Houston Methodist at least once a year.

VSD Repair
For some conditions, VSD repair may be required using one of the following techniques: 

  • Cardiac catheterization uses a thin catheter (tube) to insert a plug type device to close the hole. As heart tissue grows around the device, the hole is sealed permanently. 
  • Open-heart surgery allows surgeons to patch or stitch the hole closed through an incision in the chest. 
  • A hybrid procedure uses a combination of both surgical and catheter-based techniques.


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