6 mm VSD in 8 month old kid

[kumarms]

Hi Doc,

My daughter was diagnosed with 3mm of VSD in her 3.5month and ther reports were:
situs : Solitius/levo cardia
a-v relation : normal
v-a relation : normal
pul v connection: normal
pericardium : normal
aorta & Arch : normal
pul artery : normal
chambers: normal
septae: 3 mm restrictive perimembranous vsd , ias normal
valves : no ar,tr/pah
others: no pda, pfo+

impression : restrictive perimembranous vsd
this report was generated by a pediartic cardiologist using 2d & color doppler echocardiogram

I was advised by the doctor that the hole is small and we should be observed for closure and there are less chances for its automiatic closure as the hole is near the valve

we were advised to come after 6 months to d a follow up. we went and the report at her 8 months were :

situs solitus,levocardia
Av-VA concordance seen
IAS intact
IVS- small perimembranous VSD measuring 6mm left to right shunt with IVG of 80 mmHg
Normally related great arteries
Normal Pulmonary venous drainage
good biventricular function
aortic arch left side - d loop
no PDA/PS/Coarctation of aorta

Impression:Acyanotic congenital heart disease, small perimembranous VSDmeasuring 6mm left to right shunt with IVG of 80 mmHg

at this time also we were asked by teh doctor that this is a small -moderate VSD and do not require any surgical procedure and lets follwo up for next yaer.

Nw my kid is 23 months old and I am planning to go to meet the doc in few days for echoMy kid seems to be more active then her age kids and she feeds well, no sign of sweeting during feeding and growth rate is also at par with vaccination card.

Could you please suggest if the decison of follow up is fine, or should we go for a surgical method. What precaution should we follow for her. I will post the report once we are done with her echo and doc suggestion.

[kumarms]

A related discussion, Can she do Martial Arts was started.

[happyfather]

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[Marie M Gleason, M.D.]

Yes, this is fine.

[kumarms]

Dear Doc,

As per your advice we went for the follow up and under mentioned are the details pertaining to it:

Age of Child - 1 year 11 months
Sex- Female

Screening Echo - 7 mm restrictive VSD
partially closed septal tricuspid valve vt
Gradient - 80mmHg
No AR

Advice -
Annual Echo
Impective Endocarditis prophylaxis

The doctor advised that the VSD is partially closed now and after examining the kid suggested that there is no need for any surgical procedure now as the kid is doing well and the heart presentation is also good. Since the gradient is good he suggested us to have an annual echo performed so that we can have a watch on the VSD.

He also suggested that if any fever , or tooth related issues are encountered then that need to be informed to our pediatrician and to him as well.

Could you please look into the details and suggest me if this is fine and we should go ahead with it.

Also could you please suggest if we can have some preventive measures so that the kid can cope up well.

Thanks  

[Marie M Gleason, M.D.]

The reports suggest that the VSD is small and restrictive with no sign of high blood pressure in the lungs. This would not require a surgical intervention, but does require ongoing follow up as the child grows.  Occasionally the aortic valve can leak, or a membrane can develop under the aortic valve over time with this type of VSD, and that can occur even when the child has no symptoms.  But that is uncommon.  It seems that you are receiving appropriate advise from your doctor. I would suggest you follow up as planned.