VSD 3.4mm with 3 yrs old

[Maitane]

Hi, doctor. My daughter was detected 5mm perimembranous VSD, 3/6 heart murmur, 50 days after her birth. Now she is 3 yrs, growing well, very active & healthy.

We are yet to start any treatment. Only do echocardiogram very half or a year.

The Dec. 2010 echo result is that the VSD is 3.4 mm, partially covered by the tricuspid valve tissue to blocking part of the hole, and the base of the hole is 5.9 mm. The L-R shunt velocity is 4.29 m/s. MR-trivial, TR-trivial, PI-trivial, AI-none. But there is also a 3/6 murmur.

I learned from this forum that perimembranous VSD is near the aortic valve, and one potential dangerous is the aortic valve cusp prolapsed or valve leakage. Her VSD is perimembranous inlet & tublercular. Please let me know how is the potential dangerous of the aortic valve involved for this location?  And what should we do next?  Is she requires surgery, if the VSD did not close by itself at 5-6 yrs? and what else we need do?

Thanks a lot, doctor.

[Marie M Gleason, M.D.]

There is no particular thing that can be done to make a VSD close sooner.  A balanced diet with protein, without excess fat is good for everyone!
The differences in how murmurs sound and why some close early, late or not at all, is very individual.  But regardless of the mechanism, a small VSD should not usually impact day to day activities for your child. Please try to relax and follow the advice of your cardiologist.

[Marie M Gleason, M.D.]

Your daughter's VSD is small by the description of the recent echocardiogram.  The degree of the murmur is not as important as the fact that she has no aortic valve leakage and no evidence of high pressure on the right side of the heart.  The chance of serious problems appears small at this point in time, and it sounds like your cardiologist is recommending appropriate follow up just to make sure.  There is nothing here that sounds like it warrants a surgical intervention at this time. People can live a normal life with a small VSD.  They do not all need to be repaired.

[Maitane]

OK, I will do an echocardiogram once a year.
Thank you very much for your help, doctor :-)

[Maitane]

Thanks you very much,doctor...i really appreciate for your answer!

The last doctor we met in Dec. 2010 really said she did not require surgical in this time, only follow up once a year.

I wish her VSD can close more quickly and I am very anxious about it. I know some baby's VSD can close spontaneously in 1 or 2 yrs. It sames my daughter's VSD closed slowly... 5mm in birth, 4mm 1yrs, 4mm 2 yrs, 3.4mm 3yrs. Is there something I can do to help her to close? high protein diet? anything else?

My daughter has somewhat shorter sleep time than other children in her age. Is this a bad thing to her spontaneous closure?

I have another question: Why some children may has lower murmur with nearly the same size perimembranous VSD? And when the murmur can disappear? I know what you mean for the murmur. But I live in China, I am afraid her murmur may be a trouble thing when she go to school.

I am sorry too many questions... Thanks a lot, doctor.