Ventricular Septal Defects: A Review

Abstract

Ventricular septal defects (VSDs) account for up to 30% of all congenital cardiac anomalies and are one of the most common lesions encountered in day-to-day practice. The etiology is thought to be multifactorial inheritance but it is sometimes associated with chromosomal abnormalities such as aneuploidies and microdeletions. Most of these defects, close spontaneously and do not require treatment. Symptoms are primarily dependent upon the degree of shunt across the ventricles. Echocardiography remains the main modality of definitive diagnosis for isolated defects. Surgical repair is recommended in hemodynamically significant shunts or if there is aortic prolapse and regurgitation. Prognosis after surgical repair remains excellent especially with isolated defects but complete atrioventricular block or worsening valve regurgitation may occur in some patients. Newer techniques involving catheter based or hybrid device closures are being used in select cases such as muscular defects. Large unrepaired shunts, although uncommon in the developed world, may cause irreversible changes in pulmonary vasculature leading to Eisenmenger’s syndrome.