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Updated: Aug 7, 2026
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Indications for and results of surgery in ventricular septal defects
Insights
Surgical closure of Ventricular Septal Defects (VSDs) is recommended for large defects causing heart failure or pulmonary vascular disease. Early VSD closure, especially before age two, can reverse pulmonary hypertension and improve outcomes.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
Background:
- Ventricular Septal Defects (VSDs) are common congenital heart abnormalities.
- Large VSDs can lead to severe congestive heart failure and pulmonary vascular disease.
- Pulmonary vascular disease from VSDs may become irreversible if not treated early.
Purpose of the Study:
- To outline the indications for surgical VSD closure.
- To discuss the timing of VSD closure for optimal outcomes.
- To highlight the importance of careful patient selection for VSD repair.
Main Methods:
- Review of current clinical guidelines and practices for VSD management.
- Analysis of outcomes associated with early versus late VSD closure.
- Comparison of surgical VSD closure with pulmonary artery banding.
Main Results:
- Surgical VSD closure is indicated for large defects causing significant heart failure or pulmonary vascular disease.
- Early closure (under age two) can reverse pulmonary hypertension, while delayed closure may lead to irreversible changes.
- Primary VSD closure in infants often has lower mortality than pulmonary artery banding and late repair.
Conclusions:
- Timely surgical intervention for VSDs is crucial, particularly in cases of pulmonary vascular disease.
- Careful patient selection is essential, considering the potential for spontaneous VSD closure.
- Primary VSD repair offers a favorable alternative to staged procedures in many infant cases.
Abstract:
Surgical closure of VSDs is indicated mainly for those that are larger and causing either servere congestive heart failure or else pulmonary vascular disease. The latter, producing an increased pulmonary vascular resistance, is usually reversible if the VSD is closed under 2 years of age, but may become irreversible if left for longer times. Primary closure of the VSD, even in infants is in many centers done with a lower mortality than banding of the pulmonary artery and late VSD repair. Selection of patients needs great care because VSDs frequently get smaller or close spontaneously, even if initially large.
