The procedure takes about three hours. Most patients stay overnight in the hospital and go home the next day. Within three months, the lining of the heart wall grows over the patch and seals the hole.
Patients take medication, usually daily aspirin, for six months after the patch is placed to thin the blood and prevent blood clots while the heart heals. It is for educational purposes only and is not intended to replace the advice of your child's doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your child's provider.
Pediatric cardiac catheterization is a minimally invasive procedure used to diagnose and repair certain heart problems. Learn what to expect. American Heart Association — Children's Health.
Camp del Corazon. Tetralogy of Fallot. Truncus arteriosus. Doctors often use echocardiography echo or transesophageal tranz-ih-sof-uh-JEE-ul echo TEE as well as angiography an-jee-OG-ra-fee to guide them in threading the catheter to the heart and closing the defect. TEE is a special type of echo that takes pictures of the heart through the esophagus the passage leading from the mouth to the stomach. Catheter procedures are much easier on patients than surgery because they involve only a needle puncture in the skin where the catheter is inserted.
This means that recovery is faster and easier. The outlook for children having this procedure is excellent. Closures are successful in more than 9 out of 10 patients, with no significant leakage. Rarely, a defect is too large for catheter closure and surgery is needed.
Open-heart surgery generally is done to repair primum or sinus venosus ASDs. Your child is given medicine so that he or she will sleep through the surgery and not feel any pain. During the surgery, the cardiac surgeon makes an incision cut in the chest to reach the ASD. He or she then repairs the defect with a special patch that covers the hole.
Your child is placed on a heart-lung bypass machine so that the heart can be opened to do the surgery. The outlook for children after ASD surgery is excellent. On average, children spend 3 to 4 days in the hospital before going home. Complications, such as bleeding and infection, from ASD surgery are very rare. Some children may develop inflammation of the outer lining of the heart, a condition called pericarditis PER-i-kar-DI-tis.
This causes fluid to collect around the heart in the weeks after surgery. This complication of heart surgery usually resolves with medicine. While in the hospital, your child will be given medicines as needed to reduce pain or anxiety. The doctors and nurses at the hospital will teach you how to care for your child at home. They will talk about preventing blows to the chest as the incision heals, limiting activity while your child recovers, bathing, scheduling followup medical appointments, and determining when your child can go back to his or her regular activities.
Doctors may choose to monitor and observe children who have ventricular septal defects VSDs but don't have symptoms of heart failure. This means regular checkups and tests to see whether the defect closes on its own or gets smaller.
More than half of VSDs eventually close, usually by the time a child is in preschool. Your child's doctor will let you know how often your child should be checked. Checkups may range from once a month to once every 1 or 2 years. Some infants who have VSDs don't grow and develop or gain weight as they should. These infants usually:. Doctors usually recommend extra nutrition or special feedings for these infants.
These feedings are high-calorie formulas or breast milk supplements that give babies extra nourishment. In some cases, tube feeding is needed. Food is given through a small tube that's placed through the nose and into the stomach. Tube feeding can add to or take the place of bottle feeding. This treatment usually is temporary because a VSD that causes symptoms will likely need surgery. Most doctors recommend surgery to close large VSDs that are causing symptoms or haven't closed by the time children are 1 year old.
Surgery may be needed earlier if:. Rarely, medium-sized VSDs that are causing enlarged heart chambers are treated with surgery after infancy. However, most VSDs that need surgery are repaired in the first year of life. Advances in treatment allow most children who have these heart defects to live normal, active, and productive lives with no decrease in lifespan. Many children who have these defects need no special care or only occasional checkups with a cardiologist a heart specialist as they go through life.
Small ASDs often close on their own and don't cause complications or require treatment. Children and adults who have small ASDs that don't close and don't cause symptoms are healthy and don't need treatment.
Many others who have ASDs that don't close have catheter procedures or surgery to close the holes and prevent possible long-term complications. Children recover well from these procedures and lead normal, healthy lives. Adults also do well after closure procedures. The risk of arrhythmias irregular heartbeats increases before and after surgery. Adults who have ASDs and are older than 40 are especially likely to have arrhythmias. People who had arrhythmias before surgery are more likely to have them after surgery.
Followup care. Regular followup care into adult life is advised for people who have had:. Children who have severe heart defects may be at slightly increased risk for infective endocarditis IE. IE is a serious infection of the inner lining of your heart chambers and valves. ASDs aren't associated with a risk of IE, except in the 6 months after repair for both catheter procedures and surgery. In a few situations, your child's doctor or dentist may give your child antibiotics before medical or dental procedures such as surgery or dental cleanings that could allow bacteria into the bloodstream.
Your child's doctor will tell you whether your child needs to take antibiotics before such procedures. To reduce the risk of IE, gently brush your young child's teeth every day as soon as they begin to come in. As your child gets older, make sure he or she brushes every day and sees a dentist regularly.
Talk with your child's doctor and dentist about how to keep your child's mouth and teeth healthy. When an adult has an ASD repaired, his or her cardiologist or surgeon will explain what to expect during the recovery period and when to return to driving, working, exercising, and other activities. The location and size of the hole within the septum will determine in part the consequences of the ventricular septal defect.
Small ventricular septal defects rarely cause problems. A physician usually discovers these holes by noticing an extra heart sound called a murmur , on a routine physical exam. This murmur is often not present in the first few days of life. Most of these holes will close on their own, particularly if they are in the muscular portion of the septum.
Even if these holes do not close, they will rarely cause any health problems. Rarely, these holes can be associated with the development of other heart issues that with time can become important.
Therefore, if the small ventricular septal defect does not close, the child should continue to be seen by a cardiologist for occasional checkups. Large ventricular septal defects can cause problems, often developing gradually in the first few months of life.
Before birth, the pressure on the right side of the heart is equal to pressure on the left side of the heart. As soon as the baby takes its first breath, the pressure in the lungs and the right side of the heart starts to decrease. This process is slow and usually takes about weeks for the pressure in the lungs to reach normal level.
In the first 1 to 2 weeks of life, babies with large ventricular septal defects may do very well. But as the pressure in the right side of the heart decreases, blood will start to flow to the path of least resistance i. This will gradually lead to symptoms of congestive heart failure and must be treated. Medium or moderate ventricular septal defects are more challenging to predict. Sometimes babies born with moderate ventricular septal defects will have problems with congestive heart failure like babies with large ventricular septal defects.
Others will have no problems at all and just need to be watched. Ventricular septal defects never get bigger and sometimes get smaller or close completely. This is why when a baby is diagnosed with a ventricular septal defect, most cardiologists will not recommend immediate surgery but will closely observe the baby and try to treat symptoms of congestive heart failure with medication to allow time to determine if the defect will close on its own.
Ventricular septal defects have a very characteristic murmur, to the point where a cardiologist may be able to pinpoint the location and estimate the size of a ventricular septal defect just by how it sounds.
However, a murmur is often not heard at birth. It is only with time and pressure changes that flow across the hole between the pumping chambers can be heard as a murmur.
A smaller hole may actually make a louder noise than a large hole, and the murmur may get louder as the ventricular septal defect closes. A ventricular septal defect VSD is a defect or hole 1 in the wall that separates the lower two chambers of the heart. These chambers are called the ventricles 2 and the wall separating them is called the ventricular septum.
A child can have single or multiple ventricular septal defects. Ventricular septal defects also occur in association with more complex heart defects such as Tetralogy of Fallot and transposition of the great vessels. The information on this page applies to patients with a ventricular septal defect and an otherwise normal heart.
Ventricular septal defects can be further described by 1 size of the defect, 2 location of the defect, 3 whether there is more than one defect present, and 4 the presence or absence of a ventricular septal aneurysm. The size of the defect is usually described as small, moderate, or large.
In general, small defects cause no symptoms during infancy or childhood and often close spontaneously. Moderate and large defects are less likely to close spontaneously, may result in congestive heart failure, and more often require surgical closure. Sometimes, the term restrictive or non-restrictive are used to describe the size of the defect. The term restrictive describes small defects that allow little or no blood to flow from the left side of the heart to the right side of the heart.
Non-restrictive defects are large defects that allow a significant amount of blood to flow from the left side to the right of the heart. This results in excessive blood flow to the lungs, high pulmonary artery pressures, extra work for the heart, and congestive heart failure.
Different systems for describing the location of ventricular septal defects are used. Some are located in the lower portion of the septum called the muscular septum.
Defects in this location are called muscular ventricular septal defects. Perimembranous ventricular septal defects also called membranous VSD'S are located in the membranous septum, a relatively small portion of the septum located near the heart valves. Ventricular septal defects may also be described as inlet or outlet VSDs.
These terms further describe where the defect is located. Inlet VSDs are located close to where the blood enters the ventricular chamber and outlet VSDs are located close to where the blood exits the ventricular chamber. Sometimes a ventricular septal aneurysm is seen when the echocardiogram is done.
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