Pediatric Heart Expert Forum
vsd
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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

Dear doctor
My daughter is now 1yr  4months old and weigh around  10kg.at the time of her birth(3months ) she was identified with a vsd of 0.7cm. after 1yr during a second time diagnosis another vsd of 1.6cm was detected.they utilized 2d echo and ecg for this purpose and calculated  the ratio as 5:1 l to r shunt large inlet vsd and l to r asd ratio is less than 5:1.they suggested surgery.iam worried as she is too young .if at all surgery is required what is the best age.please help me doctor.
773637_tn?1327450515
Dear Chitravarshini,

A 6 mm ventricular septal defect is typically considered moderate in size. I am not sure how the shunt you are quoting was calculated, unless she had a cardiac catheterization; echocardiographic estimates of shunting are notoriously unreliable.  However, a moderate sized defect typically causes congestive heart failure symptoms, such as getting out of breath and/or getting sweaty with feeds, with poor growth, requiring surgical repair by age 3-5 months.  Since she is 16 months old now, one of two things has happened.  Either her defect has become smaller/restrictive and does not need intervention, OR the high amount of flow across the defect and recirculating back through her lungs has damaged her lungs and caused pulmonary hypertension (high blood pressure across the lungs), which would be catastrophic for her.  Without seeing her, I cannot say what is going on with her.  You will need to talk with your cardiologist and determine what is happening now with the size of the defect and the pressure on the right side of her heart.  She may also require a cardiac catheterization to better determine what is happening.  If you are not getting the information that you need, consider a second opinion.  Of note, there are children who undergo surgical repair for this at age 3-5 months, so age 1 year is definitely not too young.
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