Two-Year-Old Boy Successfully Treated for Perimembranous Ventricular Septal Defect Through Timely Surgical Intervention
Early detection and treatment of heart conditions in children are crucial for long-term health outcomes. In this case, a two-year-old boy was diagnosed with a perimembranous ventricular septal defect (VSD), a common type of congenital heart disease. Thanks to timely medical intervention and a comprehensive treatment plan, the child made a full recovery and is now living a healthy life.
Case Overview
Patient: Male, 2 years oldDiagnosis: Perimembranous ventricular septal defectHospital: Qilu Hospital of Shandong UniversityAdmission Date: January 2022Treatment Plan: Interventional closure procedure, postoperative antibiotic therapy, anticoagulation, and intravenous fluid supportTreatment Duration: 5 days of inpatient care followed by 6 months of outpatient follow-upOutcome: Full recovery with no complications post-treatment
Initial Presentation and Diagnosis
The boy was first identified with a heart murmur during a routine check-up at the age of one. An X-ray revealed signs of cardiac enlargement, and an echocardiogram confirmed the presence of a ventricular septal defect. Despite the diagnosis, the family did not pursue further medical attention since the child showed no symptoms such as shortness of breath, pallor, excessive sweating, or fatigue.
However, during a follow-up echocardiogram, no improvement was observed in the VSD. Concerned about the child's long-term health, the parents sought further evaluation at Qilu Hospital. Upon examination, the patient was stable with no acute distress. A systolic murmur was detected along the 4th to 5th intercostal space on the left sternal border. Further diagnostic tests, including echocardiography and cardiac catheterization, confirmed the presence of a perimembranous ventricular septal defect.
Treatment Process
After thorough communication with the family and obtaining informed consent, the medical team proceeded with an interventional closure procedure. Preoperative blood tests, including complete blood count, NT-proBNP levels, and coagulation profile, were within normal limits, and no contraindications were identified.
Under general anesthesia, the patient underwent successful percutaneous ventricular septal defect closure. Postoperatively, he was prescribed cefuroxime axetil suspension for infection prevention, aspirin enteric-coated tablets for antiplatelet therapy, and normal saline for hydration. The child recovered well without fever or complications and was discharged after 5 days of hospitalization.
Postoperative Recovery and Follow-Up
Follow-up tests, including blood work and electrocardiogram, showed normal results. Echocardiography confirmed proper placement of the occluder device with no significant residual shunting at the ventricular level. The surgical site was clean, dry, and free of discharge, and the child exhibited good energy levels, appetite, and sleep patterns.
At the six-month outpatient follow-up, the child showed no signs of arrhythmia or cardiac dysfunction. His overall health was excellent, indicating a successful outcome and complete recovery from the procedure.
Key Recommendations for Post-Operative Care
To ensure continued well-being after VSD closure, the following care guidelines were emphasized to the family:
Dietary Adjustments
Reduce sodium intake to minimize cardiac workload. Encourage a diet rich in high-quality proteins to support immune function and overall development.
Infection and Injury Prevention
Minimize the risk of colds and upper respiratory infections. Avoid unnecessary injuries and promptly treat any infections to prevent complications such as heart failure.
Physical Activity Restrictions
Avoid strenuous physical activity for at least three months after surgery. If any unusual symptoms arise, seek immediate medical attention and avoid self-treatment.
Clinical Insights and Final Thoughts
Perimembranous VSD is one of the most common types of ventricular septal defects in children. Treatment options include conservative monitoring, surgical repair, and interventional closure. In this case, the patient was an ideal candidate for interventional therapy, which provided a minimally invasive and effective solution.
This case highlights the importance of timely diagnosis and appropriate treatment in pediatric cardiology. Even after successful intervention, maintaining a healthy lifestyle—including balanced nutrition, sufficient rest, and moderate physical activity—is essential for supporting long-term cardiac health in children with congenital heart defects.