Pediatric Heart Expert Forum
VSD in 8 week old
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VSD in 8 week old

My daughter is two months old.  She was born with a VSD and ASD.  The ASD is very small but the VSD is classified as moderate size (6mm).  Her growth rate is at the 25%.  She has had feeding issues since birth but exhibits NO other physical VSD symptoms.  It seems she feeds enough to get rid of hunger pains and then stops.  She doesnt tire she just acts like she is full.  10 days ago she had a bad two days where she ate little and was fussing hysterically.  We admited her to the hospital and they inserted a feeding tube and we have been nourishing her with bottle and feeding tube for the past week and it's like we have a new baby.  She has gained 12 ounces in 7 days feeding her about 25 cals per ounce, 24 ounces per day.  She is on lasix with a small dose of blood pressure medication.  Her breathing was a bit labored a few weeks back but is now normal.  Her oxygen levels are always 97% or higher and all her other vitals are normal.  The doctor recommended surgey in two weeks.  She would be 10 weeks old.  Personally, I think this was a knee jerk reaction.   I dont understand why the decision to perform surgery was recommended when she has reacted so well to the recent treatments.  If she is thriving, even with a feeding tube, and her vitals are normal than why operate now?  The cardiologist seems to think the hole has enlarged some but that is debatable to me since the three ultrasounds were performed by two different people on two different machines.  Any input would be greatly appreciated.  
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Dear Mat,

Without evaluating your daughter, I cannot say exactly what is happening and whether surgery is indicated, or not.  There are several factors that can influence whethere VSD closure surgery is required.  These include but are not limited to persistent congestive heart failure despite anticongestive therapy, poor growth despite therapy, worsening pulmonary hypertension (high blood pressure across the lungs), progressive deformation of the aortic valve, and poor likelihood of closure of a moderate or large defect (i.e. no aneurysmal tissue closing the defect).  We do occasionally give babies NG feeds to try to grow them larger so that they can either close the holes, or at least make them small enough to be restrictive to the extra blood flow and recirculation.  But, if it's not looking like the defect is getting smaller or won't be covered, it may need repair.  That said, for something as serious as this, I would recommend getting a second opinion to ensure surgery is truly indicated.
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