Pediatric Heart Expert Forum
My 4month old baby diagnosed with ASD measuring 12mm and VSD measuring...
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My 4month old baby diagnosed with ASD measuring 12mm and VSD measuring 8mm

My 4month old baby diagnosed with
- Large atrial septal defect(ASD) measuring 12mm.
- Large perimembranous venticular septal defect(VSD) measuring 8mm; in addition two muscular VSDs measuring 4mm and 2mm.
- No PDA/coarctation.
- Left-to-right (obligatory) shunt seen across VSDs.
- Right-to-left (obligatory) shunt seen across ASD.
- Trivial regurgitation of left AV valve.

Please suggest me how serious it is. My baby grown well and he has a hemoglobin count of 14.40.
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773655_tn?1340656399
You are describing significant congenital heart disease in your 4 month old child.  A 12 mm atrial septal defect (ASD) is large, but in most cases, is not associated with clinical symptoms or high pressure in the lungs (called pulmonary hypertension).  There are several types of ASDs and depending upon their location will determine if there is the possibility of spontaneous improvement over time, or whether surgery will definitely be needed (a secundum ASD may get smaller over time, while a sinus venosus or primum type of ASD will need surgery).  The 8 mm ventricular septal defect (VSD) is more worrisome as that is moderate to large in size.  VSDs can be associated with elevated pressure in the lungs and poor growth.  I am concerned that you have noted a "right to left" shunt at the level of the ASD.   That is not normal; it should be left to right.  If it is truly "right to left" then it could indicate high pressure in the lungs.   Not knowing anything else, I would say that you need to have a serious conversation with your doctors regarding the types of ASD and VSD present, and whether they feel the baby has any pulmonary hypertension.  That will determine whether surgical intervention should be considered sooner than later.  good luck.
7 Comments
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Avatar_m_tn
Many many thanks for your reply.

I want to send you the whole echo report, can you please give the email id. I want to know is my baby need immediate surgery. Can one surgery correct all the problem.

waiting for your reply.



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773655_tn?1340656399
If you and your child's doctor request a second opinion, then your doctor would have to forward the information to our hospital.  We do not review any data that comes from patients as it may be incomplete.
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Avatar_m_tn
OK, I understand.

Thanks again for reply. Actually i am a helpless father, that's why i am asking such question.
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Avatar_m_tn
Hi,

I have visited the other doctor, he give some medicine and told that before surgery he has to increase his weight up to 10kg. Can we wait till that.

I have noticed one more symptoms in my baby, some time he turn his eye up and and expand his hand and legs, looks like he is loosing his consciousness. Does this symptoms cause due to the VSD defect or it is something else.

Please suggest me.  
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773655_tn?1340656399
I do not know what the limitations to surgery are where you live.  If someone does have a serious heart porblem we do NOT wait until the child reaches a certain weight.  It may take a very long time to reach 10 kg and the damage may be done by that time.  If your child has an episode that looks like "losing consciousness" that can be VERY serious.and this needs to be discussed in detail with your doctor.  
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Avatar_m_tn
Hi,

Doctors performed BT SHUNT on my baby 4 day earlier. They told that his right side of the heart is undeveloped and he has to go through series of operation. They also said that even all surgery will be done successfully, he won't survive more than 20-25 year. Below i mentioned the finding of my doctor. Please tell me is this defect is curable.

Diagnosis : CCHD, Qp (with down arrow),TRICISPID ATRESIA, ASD, VSD, PS GR 64, CONF GOOD SIZED PULMONARY ARTERIES

2D Echo : MV/AV N, TV ATRESIA, PV PS GR 64, AO/LAES 13/13, LVES/ED 13/22, EF 60%, LV N, RA N, SS, LC, 3PV-LA, AV CONCORDANCE, NRGA, TRICUSPID ATRESIA NON RESTRICTIVE ASD, R>L, RV SMALL, NON RESTRICTIVE VSD, SEV PS, GR 64, B/L CONF GOOD SIZED ARTERIES, RT 6MM, LT 5.5 MM

Procedure : RMBTS ( 4 MM ) GORETEX GRAFT

Describe : RMBTS ( with 4 mm GORTEX GRAFT B/W RT SUBCLAVIAN ARTERY AND RPA ), AZYGOUS NOT CLIPPED

Operative Finding : RT THORACOTOMY, RT. PLEURA NORMAL, NO PLEURAL EFFUSSION. RT. LUNG TRILOBED-NORMAL IN COLOR
RT SUBCLAVIAN ARTERY - 4MM
RPA - 4MM, few COLLATERALS, LT ARCH AZYGOUS DRAINING IN SVC NO MEDIASTINAL LYMPHADENOPATHY. AZYGOUS NOT CLIPPED.
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
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