What is a ventricular septal defect (VSD)?
Some children are born with a hole in the wall between the two lower chambers of the heart, called the ventricles. This hole is called a ventricular septal defect. Because the hole can vary in location and size, the cardiologist may observe the child to see whether the hole will close on its own. Many holes need to be closed with cardiac surgery. An operation called a pulmonary artery banding may be done to relieve severe symptoms. Later the band can be removed and the defect can be repaired with open heart surgery.
Preparing for the procedure
Prior to cardiac surgery, this heart defect will be diagnosed with an EKG, a chest x-ray and an echocardiogram. Some children require cardiac catheterization to measure the pressure in the lungs. In addition, blood tests are conducted to be sure that there is no infection and no problem with clotting, and that normal electrolyte levels are in the blood. A blood test to determine the blood type and compatibility will be performed so that blood will be available for the surgery.
During the procedure
The child will be placed under general anesthesia, and special monitoring intravenous lines will be put in. The chest is entered through the sternum (breastbone). The heart/lung machine is then connected. With the heart stopped and empty, the right atrium is then opened. Working through the tricuspid valve, the hole is visualized and repaired with a synthetic patch. The heart is then allowed to fill and beat. A drainage tube is placed and temporary pacemaker wires are usually placed to be used, if needed. The chest is then closed. The child is allowed to awaken from anesthesia in the Pediatric Intensive Care Unit and is taken off the breathing machine within a few hours. Occasionally, the child may remain on the breathing machine overnight.
After the procedure
After surgery the child will need a number of days to recover from anesthesia, from the use of the heart-lung bypass machine and from the surgery. Initially, the child will be on a ventilator (breathing machine) and may need support from intravenous medicines and a temporary pacemaker. Once the breathing tube (endotracheal tube) is out, the main goals are for the child to return to normal activity and to resume normal eating and gain weight.
Click here for recovery guidelines after discharge for congenital heart defect repair at the Inova Heart Center.