Pediatric Heart Expert Forum
9mm VSD in newborn
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9mm VSD in newborn

My newborn son was just diagnosed with a 9mm VSD.  He does breath a bit hard and tires easily during feedings.  He is very strong and alert.  The appointment showed an enlarged heart due to the extra workload.  I believe the liver was palpable also.  There were good femoral pulses.  Oxygen saturation level was 96.  When we left the hospital he was 7.2 lbs and yesterday at the cardiologist was up to 9.7 lbs.  They put him on digoxin and lasik (sorry for spelling).  My questions are #1 - Is surgery going to be required?  #2 - if so, can they do the repair with a cath procedure?  I believe the VSD is near the top to mid section of the wall.  Thank you for your time.
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Dear JL,

Without evaluating your son, I cannot say for sure if his VSD will require repair.  Certainly, with a 9 mm defect, the likelihood is definitely higher.  As well, since it sounds like he has symptoms of congestive heart failure (breathing harder/sweating with feeds), he may not be able to go without repair.  The medications can be helpful in decreasing CHF symptoms AS LONG AS he is able to grow and make the defect smaller.  He doesn't have to close it all the way; it just has to be small enough to limit the amount of flow through the defect so that he doesn't have these extra symptoms.  However, a defect of that size is less likely to allow that to happen.

Finally, this is typically not done in infants by catheterization; it requires surgery, especially if it is a perimembranous/conoventricular defect.
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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