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Ventricular Septal Defect
What is a Ventricular Septal Defect?
A Ventricular Septal Defect (VSD) is a congenital heart defect. Congenital means present
at birth. They occur early in pregnancy often before a mother even knows she is pregnant.
A defect of the heart can vary in severity from a simple problem to a more serious
abnormality.
The heart has two ventricles, the left ventricle and the right ventricle. These are the lower
pumping chambers of the heart. The right ventricle pumps blood to the lungs to receive
oxygen and the left ventricle pumps this oxygenated blood out of heart to the body.
A VSD is a “hole” (an opening) in the wall between these two pumping chambers. This
causes oxygen-rich blood (red blood, see diagram below) to leak from the left side of the
heart, where the pressure is higher, to the right side of the heart. The blood from the right
side is pumped backed to the lungs.
A VSD can sometimes be identified during a prenatal ultrasound but can be difficult to
see. Many are not diagnosed until after birth.
What are the causes of VSD?
VSD is one of the most common congenital heart defects diagnosed in the first year of
life. VSD accounts for 20-30% of congenital heart abnormalities.
Some congenital heart defects may have a genetic link causing heart problems to occur
more often in certain families. VSD can be associated with chromosomal problems, the
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most common being Down syndrome. Some medications and maternal conditions are
associated with a VSD. But most often a VSD occurs by chance and can happen to
anyone.
What does this mean?
During pregnancy, a VSD is well tolerated by the baby as the baby does not need to use
his/her lungs and the heart does not need to send blood to the lungs to pick up oxygen.
The placenta and umbilical cord carries oxygen to the baby.
What other tests should we consider?
It is important to check the baby for other abnormalities. Further tests include a detailed
ultrasound that is used to assess the baby’s other organs. A fetal echocardiogram, which
is a detailed ultrasound of your baby’s heart, will also be done.
An amniocentesis to look for chromosome problems will be offered. During an
amniocentesis, a small amount of amniotic fluid is taken from the area around the baby
and tested for genetic problems.
What will happen around the time of the baby’s birth?
VSDs can vary in size from very small to very large. Some small VSDs close on their
own and need no treatment. If the hole is large, too much blood can flow to the lungs
forcing the heart to over work, making it bigger. To prevent lung and heart problems,
larger holes usually need to be fixed sometime after birth with surgery by applying a
patch or by sewing the hole closed.
What does this mean for my baby’s future?
If the chromosomes are normal and there are no other abnormalities other than the VSD,
the outlook for these children is excellent with normal growth, development, and life
expectancy.
What do we do now?
You will meet with a doctor that specializes in high-risk obstetrics. A referral to a
paediatric cardiologist (heart specialist for children), and potentially a genetics specialist,
will be made to discuss with you the care the baby will need after birth. These doctors
will discuss with you in detail your options for further testing, discuss with you test
results and provide you with treatment options. They will be able to answer any questions
you may have.
Where can I get more information?
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Sick Kids Toronto
Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD) Repair
http://www.aboutkidshealth.ca/EN/RESOURCECENTRES/CONGENITALHEARTCON
DITIONS/TREATMENTOFCONGENITALHEARTCONDITIONS/SURGICALCORR
ECTIONOFCONGENITALHEARTDEFECTS/Pages/ASD-and-VSD-Repair.aspx
The Children’s Hospital of Philadelphia
Ventricular Septal Defect (VSD)
http://www.chop.edu/service/cardiac-center/heart-conditions/ventricular-septal-defectvsd.html
The Children’s Heart Institute
Congenital Heart Defects: Ventricular Septal Defects (VSD)
http://childrensheartinstitute.org/educate/defects/vsd-1.htm
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