Ventricular septal defect (VSD) surgery | Dr Samson Olori

What is a ventricular septal defect?

A ventricular septal defect (VSD) is a hole in the wall between the two lower chambers of the heart (ventricles). It is one of the most common congenital heart defects. Small VSDs may cause no symptoms and sometimes close on their own. Larger VSDs allow extra blood to flow to the lungs and can cause difficulty breathing, poor growth, rapid breathing, pale or bluish skin, frequent chest infections, and heart failure. Without repair, large VSDs can lead to permanent lung damage (pulmonary hypertension) or other complications. Rarely, a VSD can be acquired later in life (e.g. after severe chest trauma).

Diagnosis and treatment

Diagnosis is based on symptoms, examination (heart murmur), and tests such as echocardiography (including transoesophageal or bubble study) and sometimes MRI. Small VSDs with no symptoms may be watched. Larger VSDs or those causing symptoms usually need closure. Repair is often done with open-heart surgery: the hole is closed with stitches or a patch. In some cases, certain VSDs can be closed with a catheter-placed device. Before surgery, medication (e.g. for heart failure) may be used to stabilise the patient. Surgery has a high success rate and good long-term outcomes; recovery depends on the size of the defect and any other heart problems. We can refer you or your child to a paediatric or adult congenital heart team.

Causes, risk factors and recovery

VSD is usually present at birth (congenital). The exact cause is often unknown; genetic factors and maternal health in pregnancy can play a role. Risk factors include family history of congenital heart disease and conditions such as Down syndrome. After repair, most children spend a few days in hospital and then recover at home. Wound care, avoiding heavy activity for a period, and follow-up with the cardiologist are important. The outlook is generally excellent; a small number of children need further treatment for residual problems or rhythm issues. We can refer you or your child to a paediatric or adult congenital heart team.

Frequently asked questions

Do all VSDs need surgery?
No. Small VSDs may be watched and sometimes close on their own. Medium or large VSDs, or those causing symptoms or complications, usually need closure by surgery or sometimes a catheter device.
Is VSD repair safe?
VSD repair is a well-established procedure with a high success rate when performed by an experienced team in an appropriate centre.
Can adults have VSD?
Yes. Some people have a VSD that was not diagnosed in childhood. These are managed by cardiologists with experience in adult congenital heart disease.
What is recovery like after VSD repair?
Most children stay in hospital for a few days to a week. Full recovery usually takes several weeks. Your cardiologist will advise on activity and follow-up.