) أ.م.د. احمد عبداالمير دفار ( اختصاصي جراحة الصدر و القلب و االوعية الدموية
1
VENTRICULAR SEPTAL DEFECTS
Objective :
To show the definition and management of VSD (
Ventricular Septal
Defects)
A ventricular septal defect (VSD) is a hole in the interventricular septum (IVS). VSD,
in its isolated form, is the most commonly recognized congenital heart defect and
represents 30% to 40% of all congenital heart malformations at birth.
Pathophysiology
left-to-right shunting of blood across the defect and a marked increase in pulmonary
blood flow occurs.
The magnitude of the shunt across a VSD depends on the size of the defect.
Eisenmenger’s complex develops when the pulmonary vascular resistance becomes
highly elevated leading to reversal of shunting ( right to left)
Clinical features
Tachypnea, poor feeding, growth failure, recurrent respiratory tract infections,
exercise intolerance. Eisenmenger’s complex or cardiac failure may develop if a large
VSD is not treated early.
Those with a small VSD are either asymptomatic or are minimally sympyomatic.
Examination
A pansystolic murmur is heard in the left lower sternal border.
Investigations
- Chest Radiograph
It may be normal apart of plethoric lungs for small VSDs.
The pulmonary arteries may be enlarged with plethoric lungs & possibly
cardiomegaly if the presentation is late for large VSDs.
- Electrocardiogram
There may be ECG findings
- Echocardiography
It's diagnostic
- Cardiac Catheterization
For further evaluation
.
Treatment
) أ.م.د. احمد عبداالمير دفار ( اختصاصي جراحة الصدر و القلب و االوعية الدموية
2
Surgery is indicated for large VSDs or for those VSDs which didn't close spontaeously