Aa
opinion about VSD
my grand son age 10 days has large VSD , Echo segmental sequential Analysis is below
Levocardia
Atrial situs solitus
Normal venous connections
Atrio ventricular concordance
intact IAS
A large perimembranous outlet subaortic VSD , un- restrictive ,shunting left to right
No LVOT obstruction
LV is Dilated
Mild TR
Normal bi-ventricular function
No AR
Mild RVOT obstruction
No PDA
Normal left aortic
conclusions
Large perimembranous outlet subaortic VSD
Severe pulmonary hypertension
i want to know that need surgery or not weight is 2.6 kg
Doppler PV=15mmHg
i will be thankful to you ,
Regards
Rashid Ahmed Nadeem
Levocardia
Atrial situs solitus
Normal venous connections
Atrio ventricular concordance
intact IAS
A large perimembranous outlet subaortic VSD , un- restrictive ,shunting left to right
No LVOT obstruction
LV is Dilated
Mild TR
Normal bi-ventricular function
No AR
Mild RVOT obstruction
No PDA
Normal left aortic
conclusions
Large perimembranous outlet subaortic VSD
Severe pulmonary hypertension
i want to know that need surgery or not weight is 2.6 kg
Doppler PV=15mmHg
i will be thankful to you ,
Regards
Rashid Ahmed Nadeem
Best Answer
This is a very difficult question for a non expert in cardiology to answer. The VSD is causing a mild obstruction to the output of the right ventricle and he has severe pulmonary hypertension. It does look as though long term this would require surgery sooner rather than later. There are two methods to close a VSD, but one option is not available for all patients, it depends on many factors. The option in question is using a catheter based technique, where the chest doesn't require opening, and the heart doesn't need to be stopped. The other option involves opening the chest, stopping the heart, and cooling the patient. The VSD is through the septum wall, which is a very delicate procedure. This is because the electrical signals run down this area, controlling heart function. It is very easy for those cells to be damaged during surgery, and even later after recovery, full heart block can occur. These problems can be overcome with electrical devices, but it's another hurdle to cross and he is so young. If the Cardiologist is recommending that intervention is necessary, then I would ask about the catheter based closure option. There is also virtually no risk from infection with this technique.
When you say natural healing, you mean to see if it closes naturally?
It can reduce in size but if large, it is unlikely it will close completely. I would have a discussion with your Doctor because they may decide to try and keep the heart more healthy using medications, and see how much the VSD shrinks. However, there are things to keep in mind. Brain development may be reduced in the first months, as nutrition delivery is a problem with heart failure symptoms. The whole body growth could be inhibited. I think an expert in this field needs to have a discussion with you. Surgery is safe, there are no complications with over 99% of operations. If the VSD shrinks a small amount, and health is maintained with meds, then a child would probably not be able to achieve the same exertion as other children in sporting activities etc. It would also mean many hospital visits for monitoring.
It can reduce in size but if large, it is unlikely it will close completely. I would have a discussion with your Doctor because they may decide to try and keep the heart more healthy using medications, and see how much the VSD shrinks. However, there are things to keep in mind. Brain development may be reduced in the first months, as nutrition delivery is a problem with heart failure symptoms. The whole body growth could be inhibited. I think an expert in this field needs to have a discussion with you. Surgery is safe, there are no complications with over 99% of operations. If the VSD shrinks a small amount, and health is maintained with meds, then a child would probably not be able to achieve the same exertion as other children in sporting activities etc. It would also mean many hospital visits for monitoring.
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