Does a ventricular septal defect affect development?

Written by Zhang Zhi Gong
Cardiothoracic Surgery
Updated on September 03, 2024
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Does a ventricular septal defect affect development? For relatively small ventricular septal defects, such as those under five millimeters, the shunt from the left ventricle to the right ventricle is minimal, hence patients may not exhibit noticeable symptoms. However, if the defect is larger, for instance, over five millimeters, a large volume of blood will flow from the left ventricle into the right ventricular system. This causes congestion in the right ventricular system and the pulmonary circulation will be flooded with blood. As the saying goes, "flowing water does not rot, nor do door hinges become worm-eaten"; however, when a large amount of blood accumulates in the pulmonary vessels, patients are prone to recurrent respiratory infections and even congestive right heart failure, which then leads to feeding difficulties. Patients feel consistently uncomfortable and have difficulty breathing, so they may be reluctant to eat, especially in young children who need considerable effort to drink milk, which requires some breath-holding. At this time, patients experience feeding difficulties, which equates to developmental delays. Therefore, larger ventricular septal defects can affect a child's development. Small defects, such as those under three millimeters, might not affect development, but larger defects do impact development and thus require timely treatment.

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Written by Di Zhi Yong
Cardiology
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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.

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Written by Xie Zhi Hong
Cardiology
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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.

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Written by Di Zhi Yong
Cardiology
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Can people with ventricular septal defect swim?

If the patient has a ventricular septal defect, swimming can lead to ischemia and hypoxia, and thus, it is not advisable for the patient to swim. If symptoms such as palpitations or breathing difficulties occur, this can be very dangerous, and I would personally advise against going into the water. It is also crucial to actively treat this congenital heart disease. I suggest that the patient should undergo a cardiac echocardiography at a hospital for a clearer diagnosis. Currently, the treatment mainly focuses on symptomatic treatment, and it is recommended that the patient considers surgical options to alleviate the suffering and improve the condition. During this period, attention should also be paid to a healthy diet, especially avoiding spicy and stimulating foods.

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Written by Xie Zhi Hong
Cardiology
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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.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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What are the symptoms of ventricular septal defect?

What are the symptoms of a ventricular septal defect? In normal individuals, there are no defects between the ventricular septa. However, if there is a small ventricular septal defect, such as less than five millimeters, typically ranging between two to three millimeters, this minor defect functions like small gaps between normal windows and doors, causing minimal shunting which generally does not significantly impact the patient, resulting in no obvious symptoms. However, if the defect is relatively large, such as exceeding five millimeters, causing significant left ventricular blood to shunt to the right ventricle, it can lead to congestion in the right ventricular system or pulmonary circulation. Under such conditions, patients may frequently experience respiratory infections, congestive heart failure, or in children, reluctance to eat, presenting feeding difficulties and developmental delays. Of course, if the defect continues to enlarge, achieving a size larger than the patient's aorta, the patient may show signs of significant right heart failure due to the damaged ventricular septum, necessitating emergency surgical intervention.