Related Experiment Videos
Ventricular Septal Defect.
1Harvard Medical School and Massachusetts General Hospital, 55 Fruit Street, VBK 615, Boston, MA 02114-2696, USA.
Current Treatment Options in Cardiovascular Medicine
|November 30, 2000
Summary
Most childhood ventricular septal defects (VSDs) close spontaneously. Surgical intervention for VSD is reserved for specific cases with complications or significant defects, while device closure remains investigational.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Ventricular septal defects (VSDs) are the most common congenital heart malformations in children.
- Spontaneous closure is frequent for small VSDs, necessitating clinical monitoring and endocarditis prophylaxis.
Purpose of the Study:
- To outline current management strategies for ventricular septal defects (VSDs) in children.
- To delineate indications for surgical and investigational device closure of VSDs.
Main Methods:
- Clinical follow-up for small VSDs.
- Surgical repair for VSDs with associated lesions or functional deterioration.
- Medical management for moderate to large VSDs in infancy.
- Investigational device closure for specific VSD types.
Main Results:
- Small VSDs often close spontaneously, requiring only clinical follow-up and prophylaxis.
- Surgical closure is indicated for VSDs with specific associated lesions (e.g., aortic regurgitation, outflow obstruction) or signs of ventricular dysfunction.
- Medical management is crucial for congestive heart failure in infants with moderate to large VSDs.
- Early surgical closure (by 9 months for large, 2 years for moderate VSDs) is recommended to prevent pulmonary vascular disease and volume overload.
Conclusions:
- Management of VSDs depends on defect size, associated lesions, and clinical presentation.
- Timely intervention is critical for moderate and large VSDs to prevent long-term complications.
- Device closure shows promise but requires further investigation.