Pediatric Heart Expert Forum
Surgery Indication
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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Surgery Indication

Dear Doctor,
My child has a 5 mm vsd perimembranous, we have known since birth. We have brought her to cardiologist appointments every six months and then even waiting as long as a year as she has done well, growing, as she had no symptoms and tissue partly covering hole. She had mild left side dilation in previous visits, no medication. Now she just turned 3 years old and we had appointment last month and left side dilation has increased so they tell us surgery indicated within a year. Can this be typical to have increasing left side enlargement when child is older and to indicate surgery? I thought this matter would improve with age, not be worse. Thank you so much doctors.
773637_tn?1327450515
Dear Mariela,

Without having all of the information about your daughter, I cannot fully say what needs to be done for her.  Typically, a VSD requires closure if there is too much blood crossing the defect.  If there is tissue partially obstructing the defect, that should restrict flow across it.  However, that's not always sufficient.  It doesn't necessarily improve with age, though, which is why continued visits are necessary.  Unfortunately, real and progressive dilation to any heart chamber is not good for it in the long run, as it can lead to decreased function as well as arrhythmias.  For something like this, though, in which she has no symptoms but has chamber enlargement, I would definitely consider a second opinion to ensure that this decision is acceptable to and understandable by you.
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Thank you very much doctor. I wish I could obtain a second opinion but that would be out of my pocket and hard to do. Our doctor did take her files to meeting of panel of colleagues and they all assessed to close vsd before next summer. She still has not had symptoms or medications but the enlargement has increased much more than when she was 1 and 2 years old. I imagine with increase the symptoms eventually to show up and better to prevent this.
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