VSD Surgery for Pediatric Patients – An Overview


VSD Surgery for Pediatric Patients – An Overview

There are many infants who are found to be affected by unrestrictive VSDs (Ventricular Septal Defects). They are found to have CHF (congestive heart failure) which is refractory stated to be refractory towards medical management as well as found not to be growing. Such children are required to undergo surgical procedure to close defect, irrespective of patient’s size or age. The VSD is regarded to be an abnormal opening found within the interventricular septum which allows proper communication between the left and right hand sides of ventricular activities.
About VSD

It is a common form of congenital intracardiac defect which is of clinical importance. It might vary in number, location and size within interventricular septum. Its clinical implications will depend upon such factors. They might occur along with other forms of cardiac anomalies or as isolated lesions. VSD Closure surgery in India is best performed under the best and qualified experts in the domain.

Its history

Roger in 1879 had initially characterized VSD’s clinical presentation. Even before this date, VSD had been recognized, however, less understood. But in 1897, autopsy findings of a thirty two year old patient as per reports by Eisenmenger found cyanosis and large VSD. The syndrome is currently referred as progressive pulmonary vascular resistance elevation with reversal of cyanosis and intracardiac shunting.

Muller, at UCLA, in 1951 had performed what is being described by current surgeons as pulmonary artery band. It was performed on a five month infant suspected of having large VSD. Main pulmonary artery size was reduced. It was done by eliminating part of MPA (main pulmonary artery) wall. Then polyethylene strip was placed around stenotic area. Prior to 1951, Blalock had performed two same types of operations. However, both patients were noticed to have succumbed to death during the surgical procedure. Short term success was reported by Damman and Muller of this operation.

Lillehei and his colleagues in 1955 had performed VSD closure that turned out to be quite successful under guidance at the Minnesota University using cross-circulation. Kirklin and Dushane in 1956 had performed the initial VSD closure successfully at Mayo Clinic using cardiopulmonary bypass.
With cardiopulmonary bypass becoming widely reproducible among infants and younger children, definite reparative closure (for eliminating shunting) replaced palliative surgery (for reducing excessive flow of pulmonary blood and pulmonary hypertension).

Some complications

Few VSD complications are as follows:
  • Left heart failure
  • Growth failure
  • Severe illness (bacterial or viral pneumonia)
  • Aortic regurgitation: commonly affecting patients suffering from subarterial VSDs
  • Ineffective endocarditis: Occuring at rate of 2.1 cases/1000 patients annually
  • Stenosis in right ventricle outflow tract
  • Acquired left ventricle outflow tract obstruction
  • Discrete fibrous sub-aortic stenosis
  • Stenosis of right ventricular outflow tract
  • Paradoxical emboli
  • Aneurysm of ventricular septum
  • Sudden death
  • Impaired left ventricle function among few patients
  • Heart block that is secondary to intra-cardiac repair
  • Weight increase following VSD closure

The best VSD Closure treatment in India is sure to help patients to resume normal activities like before.

VSD Surgery for Pediatric Patients – An Overview VSD Surgery for Pediatric Patients – An Overview Reviewed by Ravish kumar on February 20, 2018 Rating: 5

No comments

Note: only a member of this blog may post a comment.