Ventricular Septal Defect
Ventricular Septal Defect is a hole in the wall between right and left ventricles. VSD is usually present before birth and is often found in the infants. The defect allows newly oxygenated blood to flow from the left ventricle to the right ventricle where the blood is de-oxygenated. The mixed blood in right ventricle flows back into the lungs. Thus the right and left ventricles work harder and pump a greater volume of blood than normal. Because of the increased load on the left ventricle, it fails to pump blood effectively than normal in due course of time. Ventricular Septal defect occurs in combination with more complex defects such as Tetralogy of fallot and transposition of great vessels.
Because of the ventricular septal defect, blood returning to heart from blood vessels back up into lungs which leads to pulmonary congestion and associated conditions such as fluid retention and weight gain. If VSD remains uncorrected, excessive pressure can build up in the lungs resulting in pulmonary hypertension. The higher the pulmonary pressure, greater are the chances of backward flowing of blood from right ventricle to the left ventricle, causing de-oxygenated blood to be pumped to the body. This results in cyanosis or bluish discoloration of skin. Ventricular septal defects vary and can be described by size of the defect, location of the defect and the number of defects.
Diagnosis of Ventricular Septal Defect
In most of the cases, the newborns with VSD do not have heart related symptoms. In moderate to large size defects, the symptoms of congestive heart failure develop during the first 2 months of life.
· Physical Examination – The presence of heart murmur is marked as the first clue that the child has VSD. The heart murmur is heard right after the birth but it may not be heard until child is 6 to 8 weeks old. If child has congestive heart failure, the common associated symptoms are – poor weight gain, higher hear rate and breathing rate with an enlarged liver.
· Medical Examination – Echocardiogram, oxygen saturation test and chest x-ray may be done to diagnose Ventricular Septa Defect. Cardiac Catheterization may also be done to confirm the diagnosis.
Treatment of Ventricular Septal Defect
The surgeries commonly done to treat Ventricular Septal Defect are –
· Intra-Cardiac technique – It is an open heart surgery performed under general anesthesia. The rib cage is cut in the midline and the heart is directly accessed with the defect sutured.
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