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Ventricular septal defect (VSD)

There are 4 morphological types

1. Membranous

2. Muscular:

3. Inlet defect close to the tricuspid valve.

4. Outlet defect close to the pulmonary valve.

Clinically a loud pansystolic murmur maximal at the left sternal border called Roger's murmur is usually present.

Treatment

VSDs are usually treated by pediatricians.

In children the corrective surgery is done if the pulmonary blood flow exceeds 1.5X systemic flow and is contraindicated if pulmonary vascular resistance exceeds 70% of systemic resistance. Ideally it is done between the ages of 3-6 yrs.

surgery is indicated in the following:

- infective endocarditis > once

- flow causes left ventricular dysfunction

- AI develops due to VSD right below aortic cusp.

In adult life medical treatment may include infective endocarditis prophylaxis and treatment of congestive heart failure.

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