How is Ventricular Septal Defects Treated?
VSD treatment depends on a child’s age, VSD size, location, and severity. There are few VSD’s which can be closed on-surgically. The non-surgical procedure usually happens in older children and If the VSD’s are away from some of the important structure of the heart. They have to be chosen very carefully by the cardiologist depending on the ECHO.
Approximately 75 percent VSDs close by its own within the first year of life and do not require any treatment other than caring monitoring. 25 percent babies who need surgical repair often have the procedure in their first year. But the baby should be closely monitored by a doctor. This is to make sure that the hole eventually closes properly and no signs of heart failure should occur.
Children who have a medium or large ventricular septal defect may need surgery to close it. Usually it’s rare for VSDs in adults to close by its own.
Some small VSDs are closed surgically to prevent further complication related to their location. It is noticed that many people with small VSDs have productive lives with a few related problems. Babies who have large VSDs may need extra nutrition to help them grow. Some babies may require tube feeding.
1. Wait and watch approach
If the VSD is small and not causing any symptoms then a doctor may recommend wait and watch approach. Your cardiologist will carefully monitor your baby’s health to make sure your babies condition improves.
Dr. Suresh Rao from Kokilaben Dhirubhai Ambani hospital says” Whenever we see a VSD in the new-born child we don’t try to rush in and close the VSD. If it is only a VSD and not with any other problem, we try to give a child a months’ time, monitor it closely on how it feeds, how it grows and at the end of one month usually the VSD shows itself, how it is going to behave in future. So generally, the VSD’s are close anywhere between two to three months upwards. But certainly, large VSD’s have to be close by the 6th month of age because we know that if we leave it for too long the large VSD can cause damage to the lungs”.
2. Ventricular Septal Defect Surgery
For large VSD doctor will recommend surgery. The surgery is required to repair the damage. Open-heart surgeries are performed to correct the VSD’s. surgery may be needed if:
1. The child fails to gain weight.
2. Medicines are prescribed to control the symptoms of heart failure.
In some VSD cases, the kids need 5 to 7 years of follow up, especially with large VSD and high lung pressure. They required a follow up to see what is happening to the lung pressure. Even a small percentage can continue to have high lung pressure- says Dr. Suresh Rao.
Babies who have shown some signs of congestive heart failure will typically be put on medication, usually a diuretic to help get rid of extra fluid in the lungs. This medication is called diuretics, include furosemide (Lasix). Many times, digoxin will be added to help increase the strength of the heart. Babies with VSD’s get tired during feeding, for them a high-calorie formula or fortified breast milk will be added to help the baby grow.
- Digoxin to increase the hearts contractions
- Beta-blockers keep the heartbeat regular
- Diuretics to decrease the number of fluids in circulation
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If your child is having surgery to repair Ventricular Septal Defect, consider having surgery performed by cardiologist or surgeon with expertise in conducting these procedures.Surgical repair:
VSD surgical procedure usually involves open-heart surgery under general anaesthesia. The doctor uses a patch or stitches to close the hole.
Dr.Suresh Rao says” For girls particularly, we perform the surgeries from the back, so that there is no scar in the front and it is only cosmetic. We assure parents that there is certainly no risk in this approach, so parents of girl child prefer that we perform the surgery from the back”.Catheter procedure:
For Closing a VSDs during catheterization doesn’t require opening the chest. Here the doctor inserts a thin tube called catheter into a blood vessel and guides it to the heart. Then the doctor uses the specially sized device to close the hole.Hybrid procedure:
The hybrid procedure uses both the techniques surgical and catheter-based. In this technique access to the heart is usually through a small incision, and the procedure may be performed without stopping the heart and using the heart-lung machine. VSD is closed through the device via a catheter placed through the incision.
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After Ventricular Septal Defect surgery, a doctor will schedule a regular follow-up to ensure remains closed and to look for signs of complications.
Dr. Suresh Rao says” VSD cases the kids need to follow up unto 5-7 years of the age, especially those with large VSD and high lung pressure. They need a follow up to see what is happening to the lung pressure. Even a small percentage can continue to have high lung pressure”.
Top 5 Hospitals for VSD treatment in India.
1. Kokilaben Dhirubhai Ambani Hospital, Mumbai
Kokilaben is the only hospital in Mumbai with Full Time Specialist System (FTSS) ensuring easy availability and access to dedicated specialists exclusively attached to Kokilaben Dhirubhai Ambani Hospital. First in India to have a 3-room Intra-operative MRI Suite (IMRIS), a diagnostic and imaging solution where the patient is never moved. Novalis TX at Kokilaben Hospital is among the world’s first whole radiosurgery systems for indications in the brain, liver, pancreas, prostate and lung.
2. Fortis Escorts, Delhi.
Fortis Escorts Heart Institute has set benchmarks in cardiac care with Paediatric path breaking work over the past 30 years. Today, it is recognised world over as a centre of excellence providing the latest technology in Cardiac Bypass Surgery, Interventional Cardiology, Non-invasive Cardiology, Paediatric Cardiology and Paediatric Cardiac Surgery.
Currently, more than 200 cardiac doctors and 1600 employees work together to manage over 14,500 admissions and 7,200 emergency cases in a year. The hospital today has an infrastructure comprising of around 285 beds (it currently enjoys 100% occupancy rate), 5 Cath Labs besides a host of other world-class facilities.
3. SRCC Hospital, Mumbai.
Narayana Health is headquartered in Bengaluru, India, and operates a network of hospitals across the country, with a particularly strong presence in the southern state of Karnataka and eastern India, as well as an emerging presence in northern, western and central India.
Our centres provide advanced levels of care in over 30 specialties, including Cardiology and Cardiac Surgery, Cancer Care, Neurology and Neurosurgery, Orthopaedics, Nephrology and Urology, and Gastroenterology.
4. Global Hospital, Chennai.
In India, Gleneagles Global Hospitals operates a chain of multi-super specialty hospitals offering tertiary and quaternary healthcare services with over 2,000 beds and state-of the-art, world-class hospitals in Hyderabad, Chennai, Bangalore and Mumbai.
A pioneer in kidney, liver, heart and lung transplants, Gleneagles Global Hospitals provides comprehensive multi-organ transplant services in the country.
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5. Artemis Hospital, Delhi.
Artemis Hospital, established in 2007, spread across 9 acres, is a 400 plus bed; state-of-the-art multi-speciality hospital located in Gurgaon, India. Artemis Hospital is the first JCI and NABH accredited hospital in Gurgaon.
Artemis has put modern technology in the hands of renowned from across the country and abroad to set new standards in healthcare. The medical practices and procedures followed in the hospital are research oriented and benchmarked against the best in the world. Top-notch services, in a warm, open centric environment, clubbed with affordability, has made us one of the most revered hospitals in the country.