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Ventricular septal defect
What would happen if the ventricular septal defect occluder dislodges?
An occluder generally works like two umbrella surfaces clamped over the orifice of the interventricular septal defect, achieving the method whereby tissue blood flow enters from the left side of the septum to the right side. Once an occluder dislodges, it can lead to a dangerous situation, as the occluder has a membrane that can easily get caught on the tendons of the mitral valve, causing severe mitral regurgitation; it can also get stuck at the mitral valve orifice, obstructing the outflow of blood; it may also lead to aortic valve insufficiency; if it gets caught in the major arteries, it can cause arterial embolism, leading to sudden death in the patient. Therefore, the dislodgement of an occluder is a very dangerous phenomenon.
What are the complications of ventricular septal defect?
The complications of ventricular septal defect mainly include the following: 1. Causes infective endocarditis, with the highest incidence occurring between the ages of 15 and 29; 2. Leads to aortic valve insufficiency; 3. Causes conductive blockages; 4. Leads to heart failure, and can even lead to Eisenmenger syndrome. Therefore, patients with ventricular septal defects should actively complete examinations such as echocardiography. If there are indications for surgery, they should promptly visit a cardiac surgeon for active surgical treatment to correct the anatomical abnormalities of the ventricular septal defect and prevent the condition from worsening and leading to serious consequences.
Does interventricular septal defect occasionally cause chest pain?
Ventricular septal defect is a type of congenital heart disease, occurring when the ventricles of the heart develop poorly during the embryonic stage, leading to a defect in the ventricular septum. This often results in a left-to-right shunt which affects the efficiency of the heart's function. In severe cases, it can cause a right-to-left shunt. Generally, these conditions do not affect the coronary circulation or cause chest pain in patients. However, some patients may develop endocarditis at the ventricular septum, which sometimes leads to the formation of vegetations on the cardiac valves or blood clots on the abdominal wall. If thrombosis or vegetations occur, there is a possibility of these breaking off. If they enter the coronary arteries, they can cause chest pain. However, such events are extremely rare, with an occurrence rate of less than one in a thousand.
Symptoms of ventricular septal defect
The main symptoms of a ventricular septal defect depend on the size of the defect and the age of the patient. Generally, smaller ventricular septal defects, such as those measuring only one to two millimeters, result in very little shunting from the left ventricular system to the right ventricular system. This is akin to a tiny amount of air seeping through a crack in a window or door. In such cases, the patient typically does not exhibit noticeable symptoms. However, if the defect is larger, over five millimeters, a significant amount of blood passes from the left ventricular system into the right ventricular system, which can cause substantial congestion in the right or both lungs of the right ventricular system, or lead to recurrent respiratory infections and congestive heart failure. The affected individual may show disinterest in eating, feeding difficulties, and delayed development. As the patient grows older, they may exhibit reduced activity endurance, fatigue or palpitations, and shortness of breath. Gradually, cyanosis and right heart failure may develop. Additionally, patients are at risk of developing infective endocarditis, fever without symptoms, and recurring fever.
Is perimembranous ventricular septal defect serious?
The ventricles are separated by the interventricular septum, which divides the left and right ventricles. Typically, after blood is ejected from the left ventricle and oxygenated by tissues, it returns to the right ventricle. The blood from the right ventricle gets oxygenated through the pulmonary artery before it can return to the left ventricle. These two should be isolated from each other before passing through the lungs. The interventricular septum consists of the membranous and muscular parts, and a defect in either part can affect oxygenation. Therefore, whether the defect is in the membranous or muscular portion is not an indicator for diagnosing the severity of the interventricular septum defect; rather, the size of the defect should be considered. Generally speaking, a defect of about 10mm in the interventricular septum, especially when accompanied by other conditions such as Tetralogy of Fallot, is considered severe. Moreover, when the defect reaches over 10mm, surgical intervention is required as minimally invasive surgery would not be feasible; these are considered severe interventricular septum defects. Also, there are cases with multiple complex defects or larger defects that should be surgically treated as soon as possible.
Can ventricular septal defect avoid amniocentesis?
Because ventricular septal defect is a type of congenital heart disease, it is recommended that patients adopt a light diet and especially avoid spicy and stimulating foods due to the condition of ventricular septal defects. It is still recommended to pursue active and early surgical treatment to improve symptoms. If there is poor cardiac function, or symptoms of palpitations and chest tightness occur, amniocentesis should not be performed as it carries certain risks. However, for milder symptoms that can be timely controlled, amniocentesis and other tests may be considered, but it is also necessary to rule out other diseases. If the patient does not have any special diseases in the past, such as coronary heart disease or diabetes, the procedure can be handled.
Can a ventricular septal defect be detected with a regular ultrasound?
Ventricular septal defect is a type of congenital heart disease, and surgical treatment is recommended for patients. Currently, to diagnose this condition, it is advised that patients undergo a cardiac echocardiography rather than just a standard ultrasound, which does not show clear results. Color Doppler ultrasound is the best way to make an accurate diagnosis and therefore determine the appropriate treatment plan. It is possible to see the size and location of the ventricular septal defect, which can significantly aid the treatment planning. Standard ultrasound may not provide a clear view and can sometimes lead to discrepancies, making treatment challenging. During this period, regular follow-up with cardiac echocardiography is still necessary, and early surgery is recommended for patients.
Can ventricular septal defect be detected during prenatal screening?
Ventricular septal defect is a type of congenital heart disease that can only be diagnosed through an echocardiogram. Routine prenatal screenings cannot detect it. Particularly for newborns, it’s advisable to have an echocardiogram, and for fetuses, a four-dimensional ultrasound is recommended. Sometimes, ultrasound results can only serve as a reference and may not indicate actual problems, but there is also a certain margin of error. If a child has congenital heart disease, it is advisable to have regular echocardiogram check-ups at the hospital. This allows timely identification of the cause, and determination of whether surgery is necessary for treatment, which is the ultimate goal.
Will being overweight affect the surgery for a ventricular septal defect?
Ventricular septal defect surgery is performed by puncturing the right femoral vein, guiding the catheter into the inferior vena cava, through the atria and ventricles, and reaching the defect via the right ventricle. The occluder can then be delivered through the catheter into the left ventricle, where the umbrella is opened, followed by opening it in the right ventricle; this describes the surgical process. Therefore, generally speaking, the surgical process is not affected in most patients who are obese. However, severe obesity can impact the accuracy of vascular localization during puncture by the surgeon. Secondly, if complications such as anesthesia issues or other emergencies arise during the surgery, severely obese patients may experience a reduced success rate in emergency surgical interventions, hence it is recommended that patients control their weight. Furthermore, severe obesity can exacerbate the cardiac load originally induced by the ventricular septal defect, thus affecting the surgical tolerance in patients whose cardiac function is already compromised by the defect. It is recommended that these patients control their weight.
If a ventricular septal defect is not surgically repaired, what will happen?
If the patient has a history of congenital heart disease, especially ventricular septal defect, it can lead to symptoms such as palpitations and chest tightness. The current recommendation for treatment is primarily symptomatic management; however, it is also advised that patients seek early surgical intervention at a hospital. Medical treatment or drug therapy often does not yield ideal results for this condition, and surgical intervention is necessary to address these symptoms. Currently, minimally invasive surgical treatment can be used. If the patient does not undergo surgery, conditions such as palpitations, chest tightness, and difficulty breathing can occur at any time.