Betweentheheart Stwopumpingchambers(Ventricles)

Note:beforereadingthespecificdefectinformationandtheimage(s)thatareassociatedwiththem,itwillbehelpfultoreviewnormalheartfunction.

Whatisit?

AVSDisanopeningorhole(defect)inthewall(septum)

betweentheheart’stwopumpingchambers(ventricles).

Whatcausesit?

Inmostchildren,thecauseisn’tknown.It’saverycommontypeofheartdefect.SomechildrencanhaveotherheartdefectsalongwithVSD.

Howdoesitaffecttheheart?

Normally,theleftsideoftheheartonlypumpsbloodtothebody,andtheheart’srightsideonlypumpsbloodto

thelungs.InachildwithVSD,bloodcantravelacross

theholefromtheleftpumpingchamber(leftventricle)totherightpumpingchamber(rightventricle)andoutintothelungarteries.IftheVSDislarge,theextrabloodbeingpumpedintothelungarteriesmakestheheartandlungsworkharderandthelungscanbecomecongested.

HowdoestheVSDaffectmychild?

Iftheopeningissmall,itwon’tcausesymptomsbecausetheheartandlungsdon’thavetoworkharder.Theonlyabnormalfindingisaloudmurmur(noiseheardwithastethoscope).

Iftheopeningislarge,thechildmaybreathefasterandharderthannormal.Infantsmayhavetroublefeedingandgrowingatanormalrate.Symptomsmaynotoccuruntilseveralweeksafterbirth.Highpressuremayoccurinthebloodvesselsinthelungsbecausemorebloodthannormalisbeingpumpedthere.Overtimethismaycausepermanentdamagetothelungbloodvessels.

WhatcanbedoneabouttheVSD?

Iftheopeningissmall,itwon’tmaketheheartandlungsworkharder.Surgeryandothertreatmentsmaynotbeneeded.SmallVSDsoftencloseontheirown.Thereisn’tanymedicineorothertreatmentthatwillmaketheVSDgetsmallerorcloseanyfasterthanitmightdonaturally.

Iftheopeningislarge,open-heartsurgerymaybeneededtocloseitandpreventseriousproblems.BabieswithVSDmaydevelopseveresymptomsandearlyrepair,withinthefirstfewmonths,isoftennecessary.Therepairmaybedelayedinotherbabies.Medicinesmaybeusedtemporarilytohelpwithsymptoms,buttheydon’tcuretheVSDorpreventpermanentdamagetothelungarteries.

ClosingalargeVSDbyopen-heartsurgeryusuallyisdoneininfancyorchildhoodeveninpatientswithfewsymptoms,topreventcomplicationslater.Usuallyapatchoffabricorpericardium(thenormalliningaroundtheoutsideoftheheart)issewnovertheVSDtocloseitcompletely.Laterthispatchiscoveredbythenormalheartliningtissueandbecomesapermanentpartoftheheart.Somedefectscanbesewnclosedwithoutapatch.ItmaybepossibletoclosesomeVSDsinthecathlab.

Ifaninfantisveryill,orhasmorethanoneVSDoraVSDinanunusuallocation,atemporaryoperationtorelievesymptomsandhighpressureinthelungsmaybeneeded.Thisprocedure(pulmonaryarterybanding)narrowsthepulmonaryarterytoreducethebloodflowtothelungs.Whenthechildisolder,anoperationisdonetoremovethebandandfixtheVSDwithopen-heart

surgery.

Whatactivitiescanmychilddo?

IftheVSDissmall,oriftheVSDhasbeenclosedwithsurgery,yourchildmaynotneedanyspecialprecautionsregardingphysicalactivityandcanparticipateinnormalactivitieswithoutincreasedrisk.

Whatwillmychildneedinthefuture?

DependingonthelocationoftheVSD,yourchild’spediatriccardiologistwillexamineyourchildperiodicallytolookforuncommonproblems,suchasaleakintheaorticvalve.Rarely,olderchildrenwithsmallVSDsmayrequiresurgeryiftheydevelopaleakinthisheartvalve. AftersurgerytocloseaVSD,apediatriccardiologistwillexamineyourchildregularly. Thecardiologistwillmakesurethattheheartisworkingnormally.Thelong-termoutlookisgoodandusuallynomedicinesoradditionalsurgeryareneeded.

Whataboutpreventingendocarditis?

Askaboutyourchild’sriskofendocarditis. Yourchild’scardiologistmayrecommendthatyourchildreceiveantibioticsbeforecertaindentalproceduresforaperiodoftimeafterVSDrepair. Seethesectiononendocarditisformoreinformation.