Management of isolated ventricular septal defects in infants and children
- David R Fulton, MD
David R Fulton, MD
- Section Editor — Pediatric Cardiology
- Associate Professor of Pediatrics
- Harvard Medical School
- Susan Saleeb, MD
Susan Saleeb, MD
- Assistant Professor of Pediatrics
- Harvard Medical School
Ventricular septal defect (VSD) is one of the most common congenital heart defects, occurring in almost 50 percent of all patients with congenital heart disease (CHD). VSDs occur in isolation or in combination with other CHD defects, as in an atrioventricular (AV) canal, tetralogy of Fallot (TOF), and, occasionally, D-transposition of the great arteries (D-TGA).
The management of infants and children with isolated VSDs will be discussed here. The pathophysiology, natural history, clinical manifestations, and diagnosis of isolated VSDs are discussed separately. (See "Pathophysiology and clinical features of isolated ventricular septal defects in infants and children" and "Echocardiographic evaluation of ventricular septal defects".)
The management of complex CHD that includes VSD is discussed separately:
●AV canal defects (see "Management and outcome of atrioventricular (AV) canal defects")
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- SMALL VSD
- MODERATE TO LARGE VSD
- Asymptomatic patients
- Symptomatic patients
- - Nutritional support
- - Medical management of heart failure
- - Follow-up
- - Management of patients with pulmonary hypertension
- CLOSURE INTERVENTIONS
- Surgical repair
- Transcatheter closure
- HEALTH CARE MAINTENANCE
- Monitoring of growth parameters
- Monitoring for symptoms of heart failure
- Exercise and sports participation
- Antibiotic prophylaxis
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS