Pediatric Heart Expert Forum
`my daughter may need surgery to close her vsd.. can anyone explain the...
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`my daughter may need surgery to close her vsd.. can anyone explain these echo results? thank you x

My 2month old daughter has a VSD which is 6mm.. anyone know anything about these ?
i was with the cardiologist thursday and he said theres a 50/50 chance she may need open heart surgery.. these are the results of the ECHO.. perimembranous vsd6mm..
left to right shunt80mmhg
normal rv/lv dimensions
LA looks slightly large
good lv fxn
clear Ao arch
no other defects..

anyone know what all this means because i cant really make it out.. all i heard was that my daughter may need surgery and her heart would have to be stopped and hooked up to a bypass machine while they put a synthetic patch on her, he said it would probly be when shes 8or9 months old.. does this mean its serious, id really appreciate if anyone could clarify this for me .. thanks hazel xx
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Dear Hazel,

Certainly, without evaluating your daughter or her studies, I can’t be sure about everything here.  However, I can tell you some things.  A ventricular septal defect (VSD) is a hole (defect) in the wall (septum) between the two pumping chambers of the heart (ventricles).  A perimembranous VSD describes where it is located, which is up near the outlet of the left ventricle.  It is a congenital defect, which means that she was born with it.  Approximately 1% of all babies born has some type of heart defect; VSD’s are amongst the most common.

At this point, it is difficult for me to know whether your child will need surgical repair for this defect, or not.  If she is eating well and not getting out of breath or getting sweaty with feeds, she may be able to grow and to close the defect herself.  All she needs to do, though, is to make it smaller—it doesn’t have to close all the way for her to avoid surgery.  Her echocardiogram (cardiac ultrasound) findings suggest that there is some, but not too much, blood recirculating through the defect back from the left to the right side of the heart.  If she had too much recirculation, the left side of the heart would be more dilated and she would probably be more symptomatic, meaning that she’d be likely to require surgical closure of her defect.

The only other issue to know is that perimembranous VSD’s have a slightly increased risk of causing problems for the aortic valve if they remain open.  The jet of blood can cause suction that can pull down one of the leaflets of the valve, which can distort the valve and not allow it to function normally.  This can lead to a leak in the valve.  This typically does not happen if the defect is surgically closed.  However, if it closes somewhat but not all the way, this can be monitored throughout her life.  That said, I would not encourage surgical closure of a small defect, because the risk is greater with the closure than with just observation of the valve and intervention IF the valve starts having problems.
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