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A ventricular septal defect (VSD) is an abnormal opening in the wall (septum) that divides the two lower chambers of the heart (ventricles). This opening allows blood from either side of the heart to cross into the opposite ventricle.

Usually, because the left side of the heart is at a higher pressure than the right side, the blood from the left ventricle flows to the right ventricle and, subsequently, back to the lungs. This abnormal shunting of oxygen-rich blood back to the oxygen-poor right side of the heart is referred to as a left-to-right shunt.

Normally, this will not cause cyanosis (bluish coloration of the skin caused by oxygen-poor blood reaching the general circulation). However, because the right side of the heart and the blood vessels in the lungs are not built to withstand increased volumes and pressures, left-to-right shunting eventually may result in heart failure and pulmonary hypertension (elevated blood pressure in the pulmonary blood vessels).

What are the signs and symptoms of a ventricular septal defect?

Signs and symptoms depend on the VSD’s size and how much blood abnormally flows  across the defect. Symptoms may include:

• Breathing difficulties

• Enlarged heart

• Irregular heart rhythm (dysrhythmias), especially atrial dysrhythmias

• Heart failure

What are surgical treatments for VSD?

The surgical option for a VSD is ventricular septal defect closure.

How is the surgery performed?

Ventricular septal defect closure is considered open-heart surgery, meaning the heart will have to be opened and the patient’s blood flow will have to be diverted to a heart-lung bypass machine during the repair.

The chest is opened via a sternotomy incision, and the patient is connected to the heart-lung bypass machine. Depending on the location of the defect, an incision will be made in the right atrium, the pulmonary artery or the outflow tract of the right ventricle (infundibulum). A patch is created by the surgeon from either the patient’s pericardial tissue or a synthetic material such as Dacron. The patch then is sutured into place to close the defect. The atrial, pulmonary artery or infundibular incision is closed with sutures, and the remainder of the operation is completed.

If the patient has no other cardiac defects, this operation usually is considered a cure and no further surgeries should be needed.

See having heart surgery for general information about preparation, surgery and post-operative recovery for congenital heart surgery procedures.