Pediatric Heart Expert Forum
VSD With L->R Shunt
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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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VSD With L->R Shunt

My Daughter was diagnosed at birth with a murmur.  It too turned out to be a VSD ranging in size from 5.3mm and an ASD to be about 1-2 mm.  She is now 7Months with 6.0kg weight. She did not require any medication but when the echo's didn't show any closure and she struggled to gain weight we had a heart catheterization procedure done.  The cardiologists reviewed the results and recommended surgery because of his pressures and his difficulty with weight gain.  Her VSD was still 5.3mm after monitoring it for 6 months.  My surgeon said that she has a PAH.
Sir, Please guide me in this matter, we are very Confuse. She is only 7 Month baby.

Thanks regards
Virendra R Padhya  
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Dear Virendra Padhya,

The concern that the cardiologists are likely telling you about is that the hole is too large to close by itself, and they are also concerned that there is too much blood recirculating through the hole back to the lungs, which can damage the lungs over the long term.  Therefore, the "PAH", or pulmonary artery hypertension, is something that needs to be eliminated by closing the hole.  However, without evaluating her, I cannot say how she will do post-operatively, as this has gone on long enough that she may be quite ill afterward.  Closing the defect will eliminate the extra blood shunting through; hopefully, the cardiac catheterization demonstrated that the pulmonary arteries (the arteries in the lungs) are reactive enough to relax and to reduce the pulmonary arterial pressure once that shunt is removed.
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