Ventricular Septal Defect (VSD) Closure

Ventricular septal defect (VSD) closure may be needed to prevent complications of a congenital heart abnormality.

A ventricular septal defect (VSD) is a structural abnormality in the heart that is present at birth. Specifically, a VSD is a hole in the inner wall (septum) that separates the two lower chambers (ventricles) of the heart. With each heartbeat, the right ventricle receives oxygen-depleted blood from the body and pumps it to the lungs, and the left ventricle receives oxygen-rich blood from the lungs and pumps it to the rest of the body. The septum normally prevents the mixing of blood between the ventricles, but a VSD alters the normal flow of blood through the heart. As a result, some oxygen-rich blood is pumped back to the lungs instead of going out to the rest of the body.

What Are the Types of VSDs?

VSDs are classified based on several factors, including:

• The size of the defect
• The location of the defect
• The number of defects
• The presence or absence of a ventricular septal aneurysm, a harmless flap of tissue that can help a VSD close on its own

When Is VSD Closure Needed?

In many cases, a relatively small (restrictive) VSD will close on its own without causing symptoms or requiring treatment. Although a larger (unrestrictive) VSD may become smaller over time, surgical closure may be needed to alleviate symptoms such as fatigue and shortness of breath. Additionally, a moderate to large VSD can lead to complications, such as heart failure, irregular heart rhythms (arrhythmias) and pulmonary hypertension.

What Does VSD Closure Surgery Involve?

Traditional VSD Closure

When performing VSD closure surgery using the traditional approach, a cardiothoracic surgeon will make an incision down the middle of the chest and separate the breastbone to access the heart. The patient will be connected to a heart-lung machine that pumps blood and functions as the heart and lungs during the surgery. The surgeon may stitch the hole closed directly or sew a tightly woven patch of manmade surgical material over the hole. If a patch is used, heart tissue will grow over it, and eventually, the hole will be completely covered with healthy heart lining tissue.

Minimally Invasive VSD Closure

As an alternative to traditional VSD closure surgery, a minimally invasive catheter-based procedure may be considered. During this procedure, an interventional cardiologist will insert a thin, flexible tube (catheter) into a blood vessel in the upper thigh and guide the catheter to the heart defect. A specially sized wire mesh implant will be passed through the catheter and plugged into the hole to permanently block blood from passing through the VSD.

Is VSD Closure Surgery Effective?

The heart and vascular surgeons at Tampa General Hospital are experienced in utilizing the latest techniques and technologies to perform VSD closure surgery and treat other structural abnormalities of the heart. We take a personalized approach to patient care with a goal to help each patient achieve the best possible outcome and quality of life. Most VSD patients do not need additional surgery unless other holes are discovered or the patch leaks.