Is VSD Closure Surgery the Right Fix for the Heart?

November 7, 2023 by Medical Content Team0
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Each year, a substantial number of individuals, from infants to adults, receive the diagnosis of Ventricular Septal Defect (VSD). This congenital heart anomaly introduces a literal “hole in the heart.” This condition is far from uncommon, affecting nearly one in every 500 babies born. VSD is a prevalent culprit, accounting for roughly 20-30% of all congenital heart defects.The intricacies of VSD lie in its varying severity and the size of the cardiac breach, which play a crucial role in determining the appropriate course of treatment. However, a ray of hope exists for those grappling with this condition—VSD closure surgery. Remarkably, this surgical intervention has a high success rate, providing a path to improved heart function and an enhanced overall quality of life.

Dr. Dinesh Kumar Mittal, an experienced cardiac surgeon with diverse specialties in cardiac surgery, deeply understands congenital heart conditions like Ventricular Septal Defect (VSD). His expertise encompasses a broad spectrum of procedures, including VSD closure. He has made significant contributions to the field, with over 5,000 adult and pediatric cardiac surgeries to his credit. Dr. Mittal’s proficiency in congenital cardiac surgery, including VSD closure, is a testament to his commitment to providing comprehensive care for patients of all ages. 

A patient’s parents said, “Dr. Dinesh Mittal is a lifesaver. My child had a complex VSD, and we were understandably anxious. Dr. Mittal’s expertise and caring approach put us at ease. The VSD surgery was successful; our child is now healthy and thriving. We immensely thank Dr. Mittal for his exceptional skills and compassionate care.”

Ventricular Septal Defect (VSD): What Is It?

VSD is a congenital heart defect that is present from birth. It’s like a little hole in the wall dividing your heart’s two bottom chambers. These chambers, known as ventricles, are essential for effective blood pumping. VSD, on the other hand, interrupts this process.

How Does It Affect Your Heart?

Let’s look at what occurs within your heart when you have VSD. 

The right ventricle of a healthy heart sends oxygen-depleted blood to the lungs, where it takes up oxygen. The oxygen-rich blood then returns to the heart and enters the left ventricle. The left ventricle circulates this oxygen-rich blood throughout your body.

In the event of VSD, however, it is a hidden tunnel between the heart’s right and left ventricles. The difficulty is that the pressure in the left ventricle is higher than in the right ventricle. As a result, the oxygen-rich blood seeps into the oxygen-depleted blood, resulting in a mix that travels to the lungs. Extra blood in the lungs might cause significant issues.

Dr. Mittal emphasizes the critical impact of Ventricular Septal Defect (VSD) on the heart. In his extensive experience, he has observed that VSD creates a direct connection between the heart’s chambers, leading to oxygen-rich and oxygen-depleted blood mixing. 

This abnormal flow burdens the heart and can potentially result in severe cardiac and pulmonary complications. Early intervention is essential to mitigate these adverse effects and ensure the heart functions optimally.

Who Is Affected By VSD?

VSD is frequently present at birth, making it a common congenital heart condition. While it is commonly diagnosed in childhood, adults can also be analyzed. However, this is uncommon (approximately 10% or fewer). VSD is significantly more likely in preterm newborns and those with specific hereditary disorders.

In rare situations, a heart attack can rip a hole between the ventricles, resulting in a VSD. This kind of VSD, known as Ventricular Septal Rupture (VSR), is a severe condition that requires rapid attention.

How Common Is VSD?

VSD affects around one-third of all babies. Adults are less likely to be diagnosed with VSD since the defect resolves on its own in 90% of instances during childhood. Due to contemporary heart attack therapies, VSDs caused by a heart attack are extremely rare. They occur in fewer than 1% of all heart attacks nowadays.

What are the Types of VSD?

Dr. Dinesh Kumar Mittal categorizes Ventricular Septal Defects (VSD) into different types based on location and structural characteristics. These types include membranous, muscular, inlet, and outlet VSDs, each with unique features. 

  • Membranous: The most common type found in the upper part of the ventricular wall.
  • Muscular: Account for about 20% of VSDs in infants and often involve multiple holes.
  • Inlet: Positioned just below the tricuspid valve in the right ventricle and the mitral valve in the left, creating a connection between both chambers.
  • Outlet (Conoventricular): This VSD forms a hole just before the right ventricle’s pulmonary valve and the left ventricle’s aortic valve, linking both chambers.

What are the Effects of VSD on the Body?

VSD seldom causes symptoms, especially when the hole is tiny. However, if a giant hole exists, blood may flow between the two chambers rather than following the regular circulation through the heart. Because of this inefficiency, your heart has to work harder. In the long run, this might cause severe symptoms and issues in the heart and lungs.

Dr. Dinesh Kumar Mittal highlights that the effects of Ventricular Septal Defect (VSD) on the body can vary. He says, “Small VSDs may not cause noticeable symptoms, but larger defects can lead to abnormal blood flow, making the heart work harder.” 

What is the Size and Impact of VSD?

VSDs exist in a variety of sizes, and the following factors determine their impact:

  • Small (3 mm or less in diameter): Most VSDs are tiny (3 mm or less) and usually close by age six. Surgery for these is uncommon.
  • Moderate (3-5 mm in diameter): These VSDs are generally asymptomatic and may close independently.
  • Large (6-10 mm in diameter): Large VSDs frequently need surgery, especially before age two, to avoid heart and lung damage. If the damage is not corrected promptly, it becomes permanent and worsens over time.

If left untreated, moderate or severe VSDs can cause Eisenmenger syndrome, which causes oxygen-depleted blood to flow in the incorrect direction and wreak havoc on your body.

What are the Causes and Symptoms of VSD?

VSD symptoms vary based on age and the size of the hole:

In Infants:

  • Shortness of breath
  • Sweating or fatigue during feeding
  • Slow weight gain
  • Frequent respiratory infections

In Older Children and Adults:

  • Fatigue or breathlessness during physical activity
  • Slightly higher risk of heart inflammation due to infections
  • Cyanosis (bluish skin or lips) in severe cases

The etiology of VSD at birth is unknown. However, it can occasionally occur with other cardiac abnormalities, diseases, or genetic illnesses. In rare situations, taking particular anti-seizure drugs during pregnancy or consuming alcohol may raise a child’s chance of getting VSD. More study is needed, however, to validate them as definitive causes.

VSD is only known to occur as a rare side effect of a heart attack, which results in Ventricular Septic rupture (VSR).

What are its Tests and Diagnosis Methods?

VSD is often diagnosed using a combination of symptoms, a physical exam, and imaging testing. A physical checkup can often show a heart murmur—a sound your doctor can detect with a stethoscope. The sound of the buzz can even be used to assess the magnitude of the problem.

Diagnostic imaging examinations include:

  • Echocardiogram: This painless test employs high-frequency sound waves to produce pictures of the heart’s anatomy, revealing VSD.
  • Electrocardiogram (ECG or EKG): When the heart shape changes, the ECG detects changes in the heart’s electrical activity, which may suggest a VSD.
  • Chest or heart X-ray: Changes in cardiac anatomy caused by VSD can be seen on chest or heart X-rays.
  • Computed Tomography (CT) scan: CT scans may provide a 3D image of the heart’s interior, which can aid in detecting VSD.
  • Cardiac catheterization: Cardiac catheterization is putting a catheter device into a blood artery to inspect the heart from the inside and determine the size and location of the VSD.

Administration and Treatment

Most VSDs are benign and frequently close on their own by age six. Surgery is typically not indicated in such circumstances. However, for VSDs of moderate or greater size, your doctor may advise surgical treatment to plug the hole. There are two primary repair methods:

  • Surgery: A cardiac surgeon uses this approach to repair or seal the hole. Depending on the size and location of the hole, it may be fixed by sewing it shut or by utilizing synthetic materials or tissue transplants.
  • Transcatheter procedures: These minimally invasive procedures employ catheters to enter the heart via a major artery. The catheter inserts a specialized occluder device into the hole, allowing heart tissue to grow over it.

Whatever approach is used, the patch or occluder will eventually become a part of the heart’s wall between the ventricles. Special treatment may be needed in some circumstances for newborns with VSD who are underweight or develop slowly.

Medication and Treatment

Medications can be used to treat VSD symptoms or while waiting for surgery. Common drugs include:

  • Diuretics: These medications promote fluid evacuation from the body to prevent fluid accumulation around the heart.
  • Heart failure medications: These aid in treating VSD and heart failure by regulating the intensity and timing of heartbeats.

Complications and Adverse Effects

Complications and adverse effects of VSD therapy may include:

  • Bleeding infections, particularly heart infections, in the first six months after surgery
  • Damage to neighboring heart valves, creating leaks
  • Heart rhythm abnormalities that may necessitate the use of a pacemaker or long-term medication
  • Following surgery to seal fresh leaks around the repair

Recovery and the Prospects

The manner of therapy determines recovery time. Transcatheter treatments have shorter recovery durations, measured in days or weeks, whereas operations have longer recovery times, generally lasting weeks or months. Symptoms typically diminish or disappear following surgery or transcatheter procedures.

Prevention

VSD is difficult to avoid since it has no identified etiology. However, you can lower the risk by avoiding alcohol and some anti-seizure drugs during pregnancy.

Long-Term Prospects

Most patients with VSD have life expectancies equivalent to those without the disorder, especially if the defect resolves independently. Repairing moderate to large VSDs often avoids complications and illnesses such as Eisenmenger syndrome. However, if a VSD is not corrected promptly, life expectancy might hurt.

Small VSDs have little effect, with 96% of persons living for more than 25 years following diagnosis. This proportion drops to 86% for mild VSDs and 61% for big, unrepaired VSDs. Eisenmenger syndrome has the poorest prognosis, with just 42% surviving at least 25 years following VSD diagnosis.

What is the Cost of VSD Closure Surgery in Delhi NCR?

The lowest cost for VSD surgery in Delhi is often between 2.0 and 2.6 lakhs, with the highest price reaching over 4.0 lakhs. However, the price may vary based on several criteria, including hospital facilities, surgeon experience, medical needs, and post-operative care.

When Should You Seek Medical Attention?

Seek medical attention. Seek care for weariness, shortness of breath, or changes in your current symptoms if you observe symptoms in your kid or an adult. In an emergency, such as trouble breathing or cyanosis (bluish skin or lips), go to the emergency room.

Conclusion

The first step in controlling this congenital cardiac problem is to understand VSD. Despite having VSD, many people may have a healthy and meaningful life with early diagnosis and adequate treatment. If you have concerns about your or your child’s heart health, please contact your healthcare professional for advice and assistance. Let us work together to keep your heart healthy!

Frequently Asked Questions (FAQs)

1. What causes VSD in newborns?

The exact cause is unknown but may be linked to other heart issues, genetic factors, or maternal drug use.

2. Can VSD close on its own without surgery?

Yes, small VSDs (holes 3mm or less) often close naturally as a child grows.

3. Are there non-surgical treatment options for VSD?

Yes, transcatheter procedures can sometimes be a minimally invasive surgery alternative.

4. What is Eisenmenger syndrome, and how is it related to VSD?

Eisenmenger syndrome is a complication of uncorrected VSD, causing blood to flow in the wrong direction in the heart.

5. How long is the recovery period after VSD surgery?

Recovery time varies, but transcatheter procedures generally have shorter recovery durations than surgical approaches.

Read Also: How is Total Arterial CABG Beneficial for Cardiac Wellness and Longevity of a Patient’s Life?


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