Ventricular Septal Defect (VSD) Repair: surgery & catheter procedure -Iran

Ventricular septal defect (VSD) repair: surgery and catheter procedure

Ventricular septal defect (VSD) is the most common congenital heart disease. If VSD is mild it can be repaired on its own, but for medium and large size VSDs the surgical repair is done. The surgery can be done in two different methods depending on defects.

What is VSD?

A ventricular septal defect is a hole between the septum of heart’s lower chambers (ventricles). The heart septum prevents the mixture of blood between two sides of the heart. But, VSD interferes with the normal function of the septum and allows the blood to pass from the left to the right side of the heart. So, oxygen-rich and oxygen-poor blood is mixed and oxygen-rich blood pumps to the lungs instead of flowing out into the aorta. It also causes extra workload on the right side of heart.

The most common cause of ventricular septal defect (VSD) is congenital. Some people may have no symptoms though they have already been born with this disease. Children who suffer from ventricular septal defect may experience symptoms such as rapid breathing, pale and bluish skin and frequent respiratory infections. They also cannot gain weight.

Ventricular septal defect repair

Ventricular septal defect or VSD can be treated in two different ways depending on the nature of the ventricular septal defect, associated side effects, and the presence or absence of aneurysm. Small VSDs are usually treated without any treatment. They get closed on their own and do not cause any symptoms. However, medium ventricular septal defects (VSDs) are less likely to close on their own and they may need surgical treatment. Large ventricular septal defects or VSDs might lead to symptoms during the patient’s early childhood and infancy. Large VSDs that often cause symptoms are less likely to close on their own and surgery is usually needed.

Types of ventricular septal defect (VSD) repair procedures

1- VSD repair by cardiac Catheter Procedure

Until 1990, the soul repair method for closing ventricular septal defects was surgery. But, now catheter procedures can be performed to close the ventricular septal hole. A catheter procedure for the ventricular septal defect repair is done under general anesthesia. During the cardiac catheter procedure, a catheter is inserted into a vein in the groin and threaded to the septum. The catheter is a thin, flexible tube that carries a tiny umbrella_ like device. The surgeon uses catheter to move that small mesh device to VSD area.

When the catheter reaches the ventricle septum, the surgeon pushes out the catheter and positions mesh device so the device plugs the hole. The device flattens against the heart septum on both sides. The doctor secures the device in right place and withdraws the catheter from the patient’s body. The device remains in the heart permanently. Within 6 months, normal tissue gradually grows over the device and it won’t need to be replaced as the child grows. The catheter repair outlook for children having the catheter procedure is excellent. Ventricular septal defect (VSD) Closures are successful without significant leakage.

2- VSD repair by Intra-Cardiac Surgery

When medical management does not work and VSD is not closing on its own, patients should undergo surgery. VSD repair by Intra-Cardiac Surgery is done under general anesthesia. VSD is inside the heart, so for doing the procedure, the surgeon should initially drain the heart blood. Thus, he/she uses the cardiopulmonary bypass during the surgery. In this technique, a machine circulates the blood from the heart and lungs. It removes carbon dioxide and supplies oxygen. When the heart is drained, the surgeon safely opens the hole. Then he/she closes the hole by a patch.

The patch is typically made of synthetic material. The surgeon stitches it using sutures. When it is closed, the surgeon closes the heart and removes the cardiopulmonary bypass machine. Over time, the natural tissue grows over the patch and tightens it into the place. The outlook for children after ventricular septal defect surgery is excellent. Complications such as bleeding and infection are rarely experienced.

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