5mm VSD

[rpateric]

My 12 day old baby is diagnosed with 5mm perimembranous VSD (medium ). Though he is not showing any symptoms now, doctors have advised us to go for surgerical treatment at the earliest ( 45 days ). He is also having small ASD ( 4mm) and tiny PDA.
Is there any chance of closing perimembranous VSD on it's own ? Are there any reliable non-surgical approaches available for VSD closure? What is the approach which we have to follow  ( like wait for some more time )? Do we need to start any medicines ?

[Marie M Gleason, M.D.]

Ventricular septal defects (VSDs) are indeed a very common form of congenital heart disease.  In a full term baby, a 5 mm VSD would be at least moderate in size.  Clinical symptoms of excess blood flow to the lungs, with rapid breathing and poor weight gain generally would not begin until the lungs relax.  This occurs several weeks to months after birth.  Depending upon the location of the VSD, there is a chance that with time it can get smaller, or even close.  This is most likely to occur if the VSD is muscular or perimembranous in location.  So there is a chance that your child's VSD could get smaller with time if the echocardiogram is accurate. The patent ductus arteriosus (PDA) and patent foramen ovale (small ASD) are normal in newborns, and close up over weeks to months.  Therefore, if your child is feeding and growing well, no medications are currently warranted.  Surgery in the first year of life is only indicated for patients who fail to thrive despite medications, or have pulmonary hypertension (elevated lung artery pressure) due to the VSD.  Given the location of your child's VSD, it seems reasonable to talk to a pediatric cardiologist and observe the child's progress before undertaking open heart surgery, which does carry risk.

[CHELLETO6DOGS]

I just want to wish you the best of luck when my son was a few hours old they heard that loud murmur 6/6, they at 2 days they found the large VSD 10mm. he was 3 1/2 months when he went for surgery (he was getting over an illness that is why they waited an extra month) we didn't know until his heart surgery that he also had an ASD (Patent Foramen Ovale) and a PDA. while they where in there they fixed it.  he did great. they put a dacron patch over his VSD (we were told that his heart was the size of a walnut and the hole in the bottom was the size of a dime) and for the ASD they stitched it . I can't tell you if there is a non surgical approach to this, basically just want to let you know I understand and a little of what we went through
from what I was told a VSD is the most common type of heart defect there is.
as far as starting medications i would say it depends on how he is thriving (growing) and if he is in heart failure. Chris wasn't doing good so they put him on lasix and digoxin plus a high calorie diet. (I think in part of him not doing so well was he was extremely ill at 5 weeks old.)
The recovery for this type of surgery I was told is really quick maybe 5-7 days in the hospital. I know it seems long, but it goes by really quickly.
I wish you and your newborn the best of luck and I know how you are feeling, we were there for the same reasons.
Michelle

[het1]

A related discussion, can recover was started.

[rpateric]

I know the pain and sorrow, which you have gone through as for these days i was not even in a position to cry for my baby. I wish you and your baby good luck and will pray.

[CHELLETO6DOGS]

Oh I am so happy for the baby. sounds like the baby is thriving to the fullest. good luck and I hope your baby continues to thrive  just so you know my son's hole was very arge and we knew he would need surgery. after surgery he still had what they called a VSD )little pin like hole around his patch (I guess this is normal) the doctors guessed it would close in a few months, well it took a few years for it to close, so if the doctor says it should close by such and such, don't worry if it doesn't that is just a guess and it might not ever close but it sounds like it is on its way to closing. good luck
Michelle

[rpateric]

Thanks a lot for your kind response.
Now last monday when the baby was 18 days old, we took another Echo. The VSD has now come down to 2mm and ASD is now 1.6 mm and PDA is absent as per the report.
Still we are worried about VSD. We are closely monitoring the baby, for any breathing discomfort which he is showing sometimes during sleep. His weight has increased from 2.9 to 3.5 Kg.
We are yet to start any medicines.