VSD (Ventricular Septal Defect)
VSD stands for ventricular septal defect. It is a very common condition in which there is a hole between the two chambers of the heart known as the ventricles. In the normal heart, there are no holes or connections between the two ventricles. If a VSD is present, blood is able to freely flow from one ventricle to another through the hole. This bypasses the way blood is normally supposed to flow through the normal heart and over time (months), the heart becomes enlarged and the patient develops heart failure. Heart failure means that the heart is working too hard and becoming enlarged and sick.
Before the modern era of surgery, patients with VSD would develop heart failure, become very sick and die in infancy or as young children. Thankfully, surgery for VSD has become a very successful and low- risk procedure that can be accomplished in patients of all ages and sizes. VSDs come in all shapes, sizes and locations, and each patient must be carefully evaluated. VSD is also commonly present in association with many much more complex congenital heart disease, and it is very important to have your evaluation at an experienced center that is familiar with all the nuances of these defects.
VSD closure still requires a patch closure using an incision and requires cardiopulmonary bypass for the majority of patients. For patch material, we prefer to use something called pericardium (the tough lining around the heart) or Gore-Tex (the same durable material that rain jackets are made from). Both are time-tested materials which produce no problems for the child as they grow, even years later.
At Rady Children’s Hospital-San Diego, patients of all ages and sizes have been undergoing successful VSD closure for more than 30 years using a standard, time-honored approach of patching. From 2009 to 2013, more than 130 consecutive VSD closures were performed as isolated procedures (meaning the VSD was the main work done) with a 100 percent success and survival rate. During the same time period, many more VSDs have also been closed by our surgeons as part of more complex procedures with similar success (see tetralogy of Fallot, AV canal and TGA for examples). This is important, as it means that the surgeons have developed vast experience closing all forms of VSD.