Ventricular Septal Defect Surgery Risks in Infants

Ventricular Septal Defect (VSD) is a common congenital heart condition in infants, where an abnormal opening exists between the heart's two lower chambers. Surgical intervention is often required to close the defect, but like any major procedure, it carries certain risks.

Risk of Residual Shunting

One of the primary concerns following VSD surgery is the possibility of residual shunting, also known as residual fistula. This occurs when a small opening remains after surgical closure. In younger or underweight infants, the heart muscle may be more fragile, increasing the chance of muscle tearing during suturing. If the remaining opening is less than 3mm and no audible heart murmur is present, it may close naturally as the child grows. However, if the residual shunt exceeds 3mm and is accompanied by a noticeable murmur, it is unlikely to resolve on its own and may require a second surgical intervention.

Potential for Heart Block

Another significant risk associated with VSD repair is the development of postoperative heart block. This condition can cause a marked decrease in heart rate. While a normal infant's resting heart rate typically ranges between 100 and 130 beats per minute, children undergoing VSD surgery may experience a drop to 60–70 beats per minute. In such cases, temporary pacing using a pacemaker may be necessary to stabilize heart function. The heart block can be caused either by surgical manipulation or by pre-existing anatomical factors. Fortunately, in many cases, this complication is temporary and may resolve as the heart recovers.

Conclusion

While VSD surgery is generally safe and effective, parents should be aware of potential complications such as residual shunts and conduction abnormalities. Close monitoring after surgery and timely medical intervention can significantly reduce the impact of these risks, leading to better long-term outcomes for the infant.