Ventricular septal defect
Ventricular septal defect is a hole between the ventricles
Ventricular septal defect closure devices
VSD Closure
Percutaneous closure of ventricular septal defect using a device
What is a ventricular septal defect?
In the normal heart, the wall separating the right and left ventricles, called the " interventricular septum ", is completely hermetic. Ventricular septal defect (VSD) corresponds to the presence of a more or less large orifice in this wall, allowing the direct passage of blood from one ventricle to the other. VSDs in children are said to be congenital (i.e. present at birth). The consequences of this malformation depend essentially on its size. Depending on the medical assessment, catheterization of the right heart cavities may be proposed before deciding on percutaneous closure of the VSD.
So why is the closure of the VSD being proposed?
Ventricular septal defect closure offers several benefits for patients. Here are some of them:
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Restore normal circulation: Closing the VSD restores normal blood circulation. Oxygenated blood can then be distributed efficiently throughout the body, without overloading the lungs.
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Preventing complications: Persistence of VSD can lead to complications, such as lung infections, valve infections, heart failure, and pulmonary arterial hypertension .
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Improved quality of life: After VSD closure, patients often experience a significant improvement in their quality of life. Dyspnea during feeding decreases, and growth retardation seen in infants improves.
Procedure of VSD Closure:
The examination takes place in the interventional cardiology unit. The child is laid flat and given general anesthesia so as not to move during the procedure. The doctor performs a venous and arterial puncture in the groin and inserts a thin catheter. The catheter is guided to the heart. The device is deployed in the VSD to close it. At the end of the procedure, the groin is compressed for about ten minutes and then a pressure bandage is applied. The child is monitored in the recovery room until he or she is fully conscious and then returned to the parents. Feeding is only allowed two hours after the end of the procedure to avoid the risk of aspiration. Discharge is usually the next day after an ultrasound check.
What are the complications of a VSD closure procedure?
The higher the child's weight, the lower the risk, but despite the experience of the operators and the significant technical progress in catheters and devices, it is an invasive procedure with complications:
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allergic complications most often linked to the use of anesthesia products.
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Vascular complications at the femoral puncture site: the most common is a hematoma which results in a bluish appearance usually without consequence and disappearing after a few days. Rarely (<1% of cases), a vascular injury may require surgical repair or transfusion.
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cardiovascular complications during the hospital period : they are very rare (<0.5% of cases) of stroke, hemorrhagic effusion around the heart or displacement of the devices, which may require additional intervention, sometimes surgical.
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Cardiac complications after hospital discharge : Very rarely, displacement of the device or localized infection may occur.
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complications leading to death : they are very exceptional (<0.1%).
It is important to note that these complications are rare, and the benefits of VSD closure usually outweigh the risks.
Ventricular septal defect
Ventricular septal defect closure
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