The catheter has a tiny umbrella-like device folded up inside it. When the catheter reaches the septum, the device is pushed out of the catheter and positioned so that it plugs the hole between the atria. The device is secured in place and the catheter is withdrawn from the body. Within 6 months, normal tissue grows in and over the device. There is no need to replace the closure device as the child grows. 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. They may not be able to eat enough to gain weight. They may need:. High-calorie formula or breastmilk.
Your child may need nutritional supplements added to his or her formula or pumped breastmilk. This increases the number of calories in each ounce.
Supplemental tube feedings. Your child may need to be fed through a small, flexible tube. This tube passes through the nose, down the esophagus, and into the stomach. Your child may have tube feedings along with or in place of bottle feedings.
Babies who can drink part of their bottles may be fed the rest through a feeding tube. Infants who are too tired to bottle-feed may get all of their nutrition through the feeding tube. The goal of surgery is to close the septal opening before the lungs are damaged.
Surgery will also help babies who have trouble feeding gain a normal amount of weight. Your child's heart doctor will decide when your child should have surgery.
This may be based on echocardiogram and cardiac catheterization results. VSD may be fixed by a cardiac catheterization. In this test, a tool called a septal occluder is used with a catheter. The doctor guides the catheter through the blood vessels to the heart. Once the catheter is in the heart, the doctor closes defect with the septal occluder. Only certain types of VSDs may be closed with this method. This procedure should be done in centers that have staff with experience in doing transcatheter VSD repair.
Babies with small VSDs may have no symptoms. These children may not need medicine. If a defect is going to close, it usually happens by age 2. This can be very useful in determining the need for surgery in children who have had subtle signs of congestive heart failure but who do not have clear-cut evidence of the need for surgical repair. Many times observation is the only treatment needed, with regular checkups with the cardiologist.
This may be as infrequent as every two to three years in older children with small ventricular septal defects to as often as weekly in babies with large ventricular septal defects. Babies who have shown some signs of congestive heart failure will typically be placed on medication, usually a diuretic to help get rid of extra fluid in the lungs.
Sometimes digoxin will be added to help increase the strength of the heart. Sometimes a medication to lower the blood pressure will also be added to decrease the workload of the heart. In babies who are failing to thrive because it is too difficult for them to eat, a high calorie formula or fortified breast milk will be added to help the baby grow.
Sometimes babies get so worn out with feeding that a small tube through the nose and into the stomach is temporarily necessary to deliver the food. The goal is to control the symptoms of heart failure to allow the baby time to grow. In the meantime, the ventricular septal defect may get smaller and cause fewer problems, in which case the infant will not require surgery and will eventually not need medications. When the symptoms of a ventricular septal defect are hard to control with medicines or the baby is unable to grow, surgical closure of the defect is often recommended.
Surgical closure of isolated ventricular septal defects is uncomplicated in 99 percent or more of cases.
Some ventricular septal defects may be closed using an FDA approved closure device which is placed using a heart catheter a small plastic tube through which the device may be delivered. In infants this requires a more limited surgery to be used together with catheter placement of the device. Small ventricular septal defects which do not eventually close rarely cause any longer-term difficulties. However, depending on the location of the hole, lifelong follow-up may be required.
Children who have had their ventricular septal defects close on their own or closed completely at surgery do not need any medications, and should not be restricted in any way. Unrepaired large ventricular septal defects and some moderate ventricular septal defects can cause two problems.
First, infants may have ongoing symptoms of congestive heart failure. Infants who have poor growth due to congestive heart failure can have poor brain development during the first few years of life.
This is the time of most rapid brain development, therefore good nutrition is important for the development of the baby. In addition, babies with congestive heart failure are at higher risk for infections, particularly lung infections. If they do get a lung infection, they may not tolerate it as well as other babies and can become very sick with even a simple winter cold. Immunizations may protect against some lung infections but not all, and complications from these infections can be life-threatening.
Here are the basics:. If you have a family history of heart defects or other genetic disorders, consider talking with a genetic counselor before getting pregnant. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version.
This content does not have an Arabic version. Overview Ventricular septal defect Open pop-up dialog box Close. Ventricular septal defect A ventricular septal defect is an abnormal opening hole in the heart that forms between the heart's lower pumping chambers ventricles , as shown in the heart on the right. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter.
Show references Congenital heart defects. National Heart, Lung, and Blood Institute. Accessed Jan. Ventricular septal defect VSD.
American Heart Association.
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