VSD In a Six Month Old Baby

[kwakwesi]

Hi,
My little girl was diagnosed with two VSDs at birth (0.3cm and 0.4cm). She is 6months old now and according to our last ECG she has one VSD (0.7cm) and a pulmonary stenosis. She sometimes has a rapid heart rate and shortness of breath when she has to poop but this is usually occurs once a day or two. Her stools are not hard. There are times when she strains to poop but does not have a rapid heart rate and shortness of breath. Our cardiologist has prescribed propranolol, penicillin V, morphine and synflorix vaccine for her. My question is:
1. Will these drugs make her heart better and consequently cause the VSD to heal?
2. If not, are there any non-surgical treatments?
3. If she does get surgery, how long will she live?

[Marie M Gleason, M.D.]

It sounds to me like she might have Tetralogy of Fallot or a large VSD with significant pulmonary stenosis.  It is up to the surgeon and their expertise to decide if everything can be done at one operation, or if they have to divide it into 2 procedures.  Usually we try to do everything at once, instead of 2 surgeries, but sometimes situations exist where it must be done in 2 steps.  As far as surgical risk, that is institution and operator dependent.  You have to find out the mortality rates for your particular surgeon and hospital.  Long term medications are generally not required.  We anticipate that most patients who do well with surgery will live into adulthood.  Some patients may require more surgery to replace the pulmonary valve in the future.

[kwakwesi]

Thank you Doc for your response. It looks like the option might be surgery. Our cardiologist mention that we might need to do a BT shunt when she weighs about 10kg (she's about 6.4) and a corrective surgery later in her life. Am honestly very distressed about all this because am not too comfortable that my little girl has to have at least 2 surgeries in her life. My question again is that if we go ahead with the surgeries what are her chances going to be? Will she have a normal life or will she forever be on some kind of medication or  have surgeries performed on her?

Thanks again in advance.

[Marie M Gleason, M.D.]

If your child has a 7 mm ventricular septal defect at 6 months of age, that would be considered a large VSD.  If there is pulmonary valve stenosis (PS), the blockage of the valve may (or may not) protect the lungs from developing high pressure.  There is a certain combination of VSD and PS that is called tetralogy of Fallot (TOF).  You should ask your doctor if that is what your child has, because if it is, it will not get better by itself and will need surgery.  None of the medicines prescribed by your doctor will cause the heart to heal.  In fact, morphine andpropranolol are usually prescribed to prevent "blue sells" in children with tetralogy of fallot.  So it sounds to me like your child might have a significant heart issue that will need surgery at some point.  You should have a discussion about this with your doctor to make sure you are clear on what they feel the likely outcomes will be.