Does VSD always require treatment?
Approximately 75 percent of small VSDs close on their own within the first year of life or by age 10 and do not require any treatment other than careful monitoring. For medium to large VSDs, the spontaneous closure rate is about 5 to 10 percent. If a VSD has not closed by age 10, spontaneous closure probably will generally not occur; it is rare for a VSD in an adult to close on its own.
An adult who has a VSD without any symptoms probably does not require intervention but should have regular checkups by a physician who specializes in adult congenital heart disease. Although the VSD may not be causing heart or lung problems or symptoms, adults with unrepaired VSDs still have a higher than normal risk for heart valve problems and endocarditis, a potentially life-threatening infection of the heart.
When should an adult with a VSD seek treatment?
An adult with a VSD who develops symptoms should consult a specialist in adult congenital heart disease. Usually treatment is recommended to prevent heart and lung problems.The treatment for VSD is an operation to patch the hole between the ventricles. It usually is performed as an open-heart procedure with a chest incision and should be performed by a surgeon who specializes in adult congenital heart defects. The surgeon will close the hole with stitches (a primary repair) or by using a mesh fabric patch (a secondary repair). Eventually, heart tissue grows around and over the patch, absorbing incorporating it into the muscle.
Are there any non-surgical options available?
Some major heart centers, including Cleveland Clinic are using a catheter-based technique to repair some VSDs. In this non-surgical, investigational procedure, a long, thin tube (a catheter) is inserted into a blood vessel in the groin and guided to the area of the heart defect. Working through the catheter, the interventionalist closes the defect using a closure device. After the device is in place, the catheter is withdrawn.
Does the heart function normally following surgical repair of a VSD?
In individuals with a VSD and no other heart or lung problems, repair of the defect restores the heart’s normal function. Generally these people can engage in physical activity without restrictions. This is also true for adults with small, unrepaired VSDs.
Individuals who have complications related to a VSD, such as abnormal heart rhythms (arrhythmias) or heart valve problems, may have some activity restrictions. Cleveland Clinic adult congenital heart disease specialists recommend that anyone with a known heart defect – repaired or unrepaired – consult a cardiologist before undertaking any program of regular physical activity, sports or exercise.