Ventricular Septal Defect (VSD) Treatment

A type of congenital heart defect that is identified by a hole or opening in the wall of the heart’s lower chambers. It means this condition occurs in certain infants when they are born with a defective heart. When this hole becomes big, the blood that leaks from either of the chambers can cause lasting damage to one’s heart and lungs, and this increases the risk for heart disease. 

Most VSD in infants heal by themselves and hardly cause any serious symptoms. In the case of a larger hole, it may need repair so that further damages or complications are prevented in advance.

Types of Ventricular Septal Defect

Four types of ventricular septal defect are known to occur that differ in their location and on the hole size.

• Membranous:- Most familiar type of VSD this is visible in nearly 80 % of the people. Mostly confined to the upper part of the wall between the ventricles.
• Muscular:- Visible in 20 % of the people and more than one hole makes up the defect in the lower muscular part of the ventricular septum.
•  Inlet:- This type of VSD is known to occur where the blood makes an entry to the ventricles through the tricuspid and mitral valves. It means when blood goes in the ventricles, it must go through a VSD that links the 2 chambers.
• Outlet:- This VSD comes about just before the pulmonary valve in the right ventricle and no later than the aortic valve in the left ventricle. It means blood has to pass by the VSD along the path through both valves.

Causes of VSD

• Any known cause of VSD occurring at birth has not been established; but this severe condition can occur along with other heart defects, genetic orders or heart conditions. 
• Consuming alcohol in pregnancy or intake of certain drugs like anti-seizure medications (phenytoin) increases the risk of the child developing a VSD.
• Only a rare side-effect of a heart attack is a known case of ventricular septal defects.

Symptoms of VSD

The exact causes of ventricular septal defects are not known and depending on the size of the hole with other heart problems it can give rise to symptoms that include:

a) In infants

• Sweating or feeling tired during feeding
• Rapid breathing or shortness of breath
• Slow or reduced physical growth
• Respiratory infections occurring frequently

b) In children and adults, the symptoms can include:

• Shortness of breath, particularly when exercising or lying down, which can lead to increased breathing.
• Arrhythmia, a condition of irregular heartbeats.
• On developing Eisenmenger syndrome, the skin turns very pale or bluish, also known as cyanosis.

c) Eisenmenger syndrome

If timely treatment is not carried out in the case of a large VSD, the chances of developing Eisenmenger syndrome is very high. In this condition, irregular flow of blood causes the blood vessels inside the lungs to become rigid and constrict in size. As a result, blood pressure is raised, and this syndrome can permanently damage the blood vessels.

VSD Diagnose 

A physician who has vast experience can diagnose a VSD that is moderate to large depending on the combination of symptoms, a physical exam and an imaging test. These tests are:

• Echocardiogram
• Electrocardiogram
• Chest or heart X-ray
• Heart catheterization
• Computed tomography scan

Treatments for VSD

Depending on the signs and severity of the condition two main treatment options are suggested by the healthcare expert: medication and surgery.

1) Medications

• Diuretics: 
  • Commonly called as water pills, these are drugs that increase the production of more urine or fluid so that the body gets rid of extra salt and fluid. These drugs will make you urinate more frequently.
• Medications for Heart failure: 
• The intensity and timing of the heartbeats is regulated. Digoxin is a common drug used to treat heart failure for VSD patients. 

2) Surgery

This is the most certain way to close a VSD to seal it by surgical means. Here the heart surgeon will operate and close the hole. 

• Surgery can be simple depending on the type and location of the hole.
• In other cases, a patch of synthetic material or a graft of the individual’s tissue can be involved.
• Catheter-type surgery: A catheter can be utilized to repair the VSD. A slender and flexible tube is inserted into the blood vessel and then into the heart. Once the catheter is inside the damaged heart blood vessels, a specialized device called the occluder seals the opening in the heart.

In either of the above cases, the tissues of the heart will grow slowly around the patch or occlude device. In the end, the patch or device should become an integral part of the heart wall between the ventricles.

Complications Experienced by Patients After the Treatment

Common side-effects that can occur in patients from surgery or catheter-type procedures for a VSD include:

• Heart infections, especially within the first 6 months after surgery.
• Bleeding
• An interruption in the surrounding valves can cause them to leak.
• Arrhythmia and heart blocks that can lead to an implant of a pacemaker or prolonged treatment with the help of drugs.