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A ventricular septal defect (VSD) is a hole between the pumping chambers of the heart (the ventricles). This is one of the most common congenital heart conditions. It was first described by Dr Dalrymple in 1847 and the first successful surgery to close a VSD was performed in 1954 by Dr Lillehei in Minnesota, USA. If the defect is large it will usually need to be repaired in early childhood: most children who have this surgery do not have long-term problems and do not need long-term follow-up. Some small defects close by themselves and also don’t require follow-up.
There is also a group of adults with small ventricular septal defects who are well, but do require longer-term follow-up because of the small chance of complications developing later in life. The section that follows refers to this group of people.
The boxes below describe three of the most important problems that we see in adults with Ventricular Septal Defects
For further information about VSDs click on the links at the bottom of the page
Aortic Regurgitation
It’s a leak back through the aortic valve, which is the valve that controls blood being pumped out around your body. This means that some of the blood will leak back into the main pumping chamber of the heart.
The most common type of VSD in adults is called a perimembranous VSD. This type of VSD is positioned very close to the aortic valve. Sometimes part of the aortic valve can prolapse into the VSD, meaning that the valve becomes distorted and therefore becomes leaky.
When the aortic valve is leaky, some blood will leak back into the main pumping chamber of the heart (the left ventricle). This makes extra work for the heart and if the leak is severe it can eventually cause enlargement and weakness of the left ventricle.
We may recommend an operation to replace or repair the aortic valve. Sometimes we try medications to delay the need for surgery.
If someone with a VSD needs aortic valve surgery, the surgeon would usually close the VSD at the same procedure.
Not usually. If you notice a deterioration in your exercise tolerance or you are getting more breathless, then get in touch with your heart team so that we can check you out.
Double Chamber Right Ventricle
It is an overgrowth of muscle in part of the right sided pumping chamber, the right ventricle. It effectively divides the right ventricle into two parts, hence the name.
We think that it is caused by the jet of blood squirting through the VSD from the left ventricle to the right ventricle. In most people this doesn’t cause any problems, but in a small minority of people, when this jet of blood hits the muscle of the right ventricle it can cause the adjacent muscle to grow thicker than usual.
If the muscle thickening in the right ventricle gets too tight, it can cause narrowing of the way out from the right ventricle. This means that the right ventricle has to work much harder than usual in order to pump blood out to the lungs. This can potentially cause the pumping function of the right ventricle to gradually get weaker than normal.
If the narrowing gets too tight, we may recommend an operation to remove some of the thickened muscle that is causing the narrowing.
If someone with a VSD needs surgery for double chamber right ventricle, the surgeon would usually close the VSD at the same procedure.
Not usually. This is a rare complication, but there don’t seem to be any definite things that make you more likely to get it.
Make sure that you attend for your follow-up clinics so that we can pick up complications like this before they cause you any major problems.
Bacterial Endocarditis
It’s an infection of the interior lining of the heart, often involving the heart valves
It happens when bacteria get into the bloodstream and settle out on the inside of the heart. It is a rare condition, but is more common in people who have an existing heart condition.
It is a dangerous infection that is difficult to treat with antibiotics. It sometimes needs surgery and sometimes it can even be fatal.
Like any bacterial infection we use antibiotics. Endocarditis usually needs a long course of intravenous antibiotics and sometimes needs surgery if the antibiotics don’t successfully control the infection.
We know that the bacteria that cause endocarditis often originate from our mouths. Taking good care of your teeth and gums is really important – brushing, flossing and seeing the dentist regularly.
There is a separate section about endocarditis on this website. Click here if you want to find out more information about endocarditis.