[Ventricular septal defects in the adult]

Ventricular septal defects (VSD) are very common in children but much rarer in adults because the majority either close spontaneously or are operated. The persistent VSD are usually membranous with a small or moderate shunt without pulmonary hypertension. They are usually well tolerated clinically but are at risk of complications, mainly bacterial endocarditis and aortic regurgitation. Doppler echocardiography plays a leading part in diagnosing the site and evaluating the left-to-right shunt and its complications. Surgery may be indicated in cases of large left-to-right shunt (QP/QS > 2) and when there are complications. Patients operated for VSD in childhood are usually considered to be cured. However, anatomical, haemodynamic, functional, electric and echocardiographic abnormalities may persist, justifying long-term cardiological follow-up.