Ventricular Septal Defects

About Ventricular Septal Defects

Ventricular Septal Defects are a common congenital cardiac defect found in young children and has been described as the second most common adult congenital cardiac condition¹.

In the case of a Ventricular Septal Defect (VSD), an opening between the Left Ventricle (LV) and the Right Ventricle (RV) fails to close during foetal development. This allows blood to be shunted (or move) between the RV and the LV and into the pulmonary veins to be oxygenated in the lungs. In a VSD, there can be a build-up of blood within the pulmonary circulation that may result in pulmonary hypertension and other physical changes to the heart.

The VSD can also result in other clinical manifestations such as:

• Presence of a murmur
• Arrhythmias
• Stroke
• Poor exercise tolerance
• Heart failure/shortness of breath
• Failure to thrive
• Lethargy².

The incidence of VSD’s in the US has been estimated to be 42 per 10,000 live births or 1 in 240 children born with a VSD. Many VSD’s close naturally during the first years of life, but if small enough, some patients may not be aware of the presence of the defect until later in life where they may present with symptoms³.

Types of Ventricular Septal Defects:

A patient with a VSD may have a single defect or multiple and might be an isolated incidence or part of a complex medical condition.

• Conoventricular VSD: defect found just below the pulmonary and aortic valves
• Perimembranous VSD: defect found in the upper section of the ventricular septum
• Inlet VSD: defect is located near the mitral and tricuspid valves, this may also involve the atrium and may be called an Atrioventricular septal defect
• Muscular VSD: is the most common type of VSD and is found in the lower muscular portion of the septum⁴.

Treatment of Ventricular Septal Defects:

Treatment is determined by the size of the VSD, location and also the haemodynamic effect of the shunt that is related in the presence of a VSD. As many as 90% of VSD’s close naturally during the first years of life and require no treatment other than monitoring for signs and symptoms.

VSD’s are typically found on echocardiograms and are classified into the size of the defect. The defect size is compared to the diameter of the Aortic annulus:

• < 25% – small defect
• > 25% – < 75% – medium defect
• > 75% – large defect⁵.

Depending on the definition of the VSD, various treatment options may be discussed with your Cardiology team. If the VSD is considered small, then regular follow up to observe of the defect closes naturally may be considered.

Medical management of symptoms may be considered appropriate to allow the defect to close naturally if possible. This may include medications to reduce potential congestive cardiac failure and other clinical scenarios that will require regular review by the Cardiology team.

Surgical closure of VSD may be required if the defect is large enough to impact on the haemodynamic ability of the patient’s heart. This may be achieved through:

• Cardiac surgery
• Minimally invasive catheter-based therapy⁶.

What is Ventricular Septal Defects?

Cardiothoracic Surgeon, Dr Yishay Orr, provides a comprehensive explanation of ventricular septal defects (VSD) in the below video. Outlining what this congenital heart defect is, how frequently patients with a VSD should be monitored by a cardiologist, the symptoms, diagnosis and patient journey.

Patient Disclaimer: All content on the Hope For Hearts site is created and published online for general information purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Please see your doctor if you have any questions or concerns.