Adult Congenital VSD

Posted by Brent Fry on June 19, 1999 at 21:38:40

I have a moderate to severe VSD (Ventricular Septal Defect).
This is producing Right Heart Insufficiency symptoms of
abdominal distention, etc. which are at least moderate
in intensity.  I am 48 years old, but physically appear to
be mid-30's, thin, etc.
Primarily a congenital defect, this VSD has evidently opened
up as a result of probably endocarditis about 10 years
ago.  At that time, I began to be unable to lie recumbent
on my left side.  Gravity was evidently assisting the
RV ->> LV shunt, such that the hemodynamic imbalance induced
an immediate tachycardia.  In the last 18 months, the defect
has apparently worsened to an alarming degree.  I have a
tentative treatment arrangement with a noted hospital in
New York City.  Cleveland might also be a good place to
be treated.
As an adult, what would be the treatment procedure (operation)
required to correct this defect?  Is "large portal" a mode
of entry, and what sort of recovery time should I expect?
Thanks!
Posted by CCF CARDIO MD JMF on June 20, 1999 at 15:59:55
Dear Brent,
It appears that you are headed for surgery of this VSD.  In generaal, these surgeries are very well tolerated and you will do quite well.  I would advise that, given your age, a cardiac catheterization of your coronary arteries be performed to rule out occult coronary disease prior to undergoing open heart surgery.   In this way, both issues could be addressed if required.  Once it is clear whether you will need a combined procedure (VSD and CABG) , the surgeon could discuss the various "exposures" or incisions that could be used to repair the VSD +/- bypass arteries.  Here in Cleveland we use as small an incision as possible and have extensive experience in minimally invasive approaches to open heart surgery.  
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.