What to Do About Ventricular Septal Defect Detected in Pediatric Echocardiogram

When a pediatric heart ultrasound, or echocardiogram, is performed, it can detect a variety of congenital heart defects. One of the most common conditions identified is ventricular septal defect (VSD). This occurs when there is an abnormal opening in the wall separating the heart's two lower chambers—the left and right ventricles. As a result, blood from the left ventricle, which is oxygen-rich, flows abnormally into the right ventricle and is then pumped back to the lungs instead of out to the body. The primary goal of treatment is to close this opening, restoring normal blood flow and preventing complications.

Types and Classification of VSD

Ventricular septal defects are classified based on their location in the heart. The three main types include membranous VSD (located near the heart valves), infundibular VSD (found just below the pulmonary valve), and muscular VSD (located within the muscular portion of the septum). In addition to location, VSDs are also categorized by size—small, moderate, or large. A small VSD is typically less than 0.5 cm², a moderate VSD ranges from 0.5 to 1.0 cm², and a large or non-restrictive VSD is greater than 1.0 cm².

Treatment Options Based on VSD Type and Size

The approach to treating VSD depends heavily on both the location and the size of the defect. Small membranous VSDs often can be repaired using a minimally invasive procedure known as catheter-based closure. This technique avoids open-heart surgery and allows for faster recovery. On the other hand, larger infundibular or muscular VSDs usually require surgical intervention to properly close the hole and restore normal heart function.

Importance of Early Surgical Intervention

Non-restrictive VSDs—those larger than 1.0 cm²—can significantly impact heart function and lead to complications such as heart failure, pulmonary hypertension, or poor growth in infants. For this reason, early surgical correction is strongly recommended. Timely treatment can prevent long-term damage to the heart and lungs and improve the child's overall prognosis.