Ventricular Septal Defect (cont.)
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.
Next: What about unusual cases of VSD? »
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