Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What types of surgery are available to correct a VSD?
There are two types of surgery available to correct a VSD: the intra-cardiac technique and the trans-catheter technique. Which surgical technique is chosen is an individualized decision based upon the nature of the VSD and associated side effects on the patient's heart and lungs. The intra-cardiac approach is the most common technique and is done while the patient is under cardiopulmonary bypass (a "heart-lung machine") and is an open-heart operation. This is the procedure of choice for most children and at most pediatric surgical centers. Another technique uses surgical instruments that are passed through catheters placed in the patient's large blood vessels into the heart. This "trans-catheter approach" is generally more difficult and should only be considered on select patients and at pediatric centers that have expertise in such a procedure.
What is the outlook (prognosis) after a VSD is repaired?
After a successful surgical repair of the VSD, the two ventricles are entirely separate from each other and the circulation of the blood within the heart is normal. If the heart was enlarged, it can return toward normal size. The high pressure in the pulmonary artery should also begin to resolve. If the child's growth had slowed,
the child usually catches up within a year or two. Long-term follow-up is required. The long-term prognosis is usually excellent.
What are complications of VSD surgery?
Complications with intra-cardiac VSD surgery are uncommon. Currently, most centers have an operative mortality rate of less than
1% if the VSD is the only defect and the heart is functioning normally. Major complications are rare (1%-2%) and include heart rhythm problems and incomplete closure of the VSD. Rarely, a pacemaker insertion or a second procedure to repair the defect are necessary.
A heart murmur is the sound generated when blood flow within the heart is not smooth. Causes of heart murmurs can be functional, congenital, or caused heart valve conditions. Symptoms of a heart murmur may be none, or may include chest pain, shortness of breath, and arm, leg, and ankle swelling. Treatment of a heart murmur depends on the cause.
Birth defects have many causes and currently, are the leading cause of death for infants in the first year of life. Some of the causes of birth defects include genetic or chromosome problems. Exposure of the mother to rubella or German measles during pregnancy, or using drugs or alcohol during pregnancy. The treatment for birth defects depends upon the condition of the effected child.
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