My two years old daughter was born with a perimembranous VSD. We took her to many doctors especially last year and her diagnosis was as follows:
Small perimembranous VSD
Normal cardiac situs and segmental connections. Normal systemic and pulmonary venous drainage. No chamber dilatation or wall hypertrophy. Intact atrial septum. Small perimembranous VSD with small left to right shunt. Maximum shunt gradient 54mmHg. Normal all cardiac valves. No aortic valve regurgitation. Normal left aortic arch. Confluent pulmonary artery. There is flow acceleration at the proximal LPA with a peak gradient of 15 mmHg. Normal ventricular contraction.
The doctor told us that she doesn't require any operation because the VSD is small 2mm and he recommended us to visit him this year to make the echo again...
I would like to ask now what is the next step? Is there any risk related to her case?
We get many questions about VSDs since they are a very common cardiac abnormality in children. If the hole is small, it would not require any surgical intervention, as your doctor has told you. We do recommend intermittent follow up of perimembranous VSDs as there can be late term complications related to the body's attmept to close the VSD spontaneously. These occur in only a relatively small number of patients, but the issues include: the development of a subaortic membrane (under the aortic valve), aortic valve cusp prolapse and valve leakage, and the development of right ventricular muscle bundles. Good dental hygeine is important to prevention infections spreading to the heart valves. Otherwise there are no activity restrictions.
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