apprx 3.4 mm size restrictive mid muscular VSD, left to right shunt. PG of 28.0mm of Hg across VSD indicative of mild pulmonary hypertension. a apprx 4.8 mm size ostium secundum ASD, left to right shunt. enlargement of RA and RV. at the time of birth he was 4.5 kg body weight
after one year we again diagnosed him and it shows
small central muscular VSD 3 mm, small left to right shunt, peak systolic gradient 70 mm Hg. No ASD. normal LV systolic function (EF 62%), no other abnormality.
presently he is 1 yr 1 month old 10.5 kg of body weight, active, showing normal growth
do you think that VSD will fill on its own or it would require operation. upto what stage should we wait, if operation is required. any precautions/ suggestion
Based on the information you have given me, I cannot say whether the defect will spontaneously resolve, or not. However, I can say that it appears to be what we call hemodynamically restrictive, which means that it is letting only a limited amount of blood cross the defect and does not seem to be causing any problems. There are numerous children who have small VSDs who grow up with them remaining open and have normal lives and lifespans. They don't necessarily need to be surgically closed. I will recommend, though, good dental hygiene (teeth brushing, routine dental cleanings), as this will lower the risk of endocarditis, a serious infection of the heart. Indications for closing the defect would include worsening symptoms of heart failure, such as easily getting out of breath or sweating with activity, or having endocarditis. Based on the size of the defect as you describe it, the former is not likely to happen and the latter has a low overall chance of happening.
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