Dr. Yugal Mishra

VSD Repair Surgery

VSD repair surgery refers to the surgical closure of a ventricular septal defect (VSD), which is a common congenital heart defect characterized by a hole in the wall (septum) that separates the two lower chambers (ventricles) of the heart. VSD repair is performed to close the defect and restore normal blood flow within the heart. Here is some information about VSD repair surgery:

 

Procedure:

 

  1. Open-Heart Surgery: VSD repair surgery is typically performed using open-heart surgery techniques. The surgeon makes an incision in the chest to access the heart.
  1. Patch Closure: The VSD is closed using a patch made of synthetic material or the patient’s own tissues. The patch is sewn over the defect to seal the hole and prevent blood flow between the ventricles.
  1. Closure Technique: The specific technique used for VSD closure depends on factors such as the size and location of the defect, as well as the surgeon’s preference and experience. Common techniques include direct suture closure, patch closure, or a combination of both.
  1. Cardiopulmonary Bypass: During the procedure, the patient’s blood is rerouted through a heart-lung machine, called a cardiopulmonary bypass machine. This machine takes over the pumping function of the heart and oxygenates the blood while the surgeon operates on the heart.
  1. Postoperative Care: After the surgery, the patient is monitored in the intensive care unit (ICU) to ensure stable recovery. Medications may be prescribed to manage pain, prevent infection, and support heart function during the healing process.

 

Indications:

 

  1. Large VSD: VSD repair surgery is generally indicated for patients with large VSDs. Large defects can lead to significant shunting of blood between the ventricles, resulting in increased volume and pressure load on the heart. Closure is necessary to prevent complications such as heart failure, pulmonary hypertension, and associated heart rhythm abnormalities.
  1. VSD repair surgery is recommended for patients who experience symptoms related to their VSD. Symptoms may include poor growth, difficulty feeding, rapid breathing, frequent respiratory infections, fatigue, and exercise intolerance.
  1. Left Ventricular Enlargement: If the VSD causes enlargement of the left ventricle due to increased blood flow and pressure overload, surgery may be indicated to restore normal heart size and function.
  1. Prevention of Complications: VSD closure surgery may be performed to prevent potential complications associated with untreated VSDs, such as endocarditis (infection of the heart lining), heart failure, and the development of pulmonary hypertension.

 

Contraindications for VSD Repair Surgery:

 

  1. Small VSD with No Symptoms: Small VSDs that are not causing any symptoms or significant hemodynamic abnormalities may not require surgical intervention. In such cases, the risks associated with surgery may outweigh the potential benefits, and the condition may be managed conservatively with regular monitoring.
  1. Unstable Medical Condition: If a patient’s overall medical condition is unstable, with severe multi-organ dysfunction, uncontrolled infections, or respiratory failure, VSD repair surgery may be contraindicated. The risks associated with surgery may outweigh the potential benefits, and efforts may focus on stabilizing the patient’s condition through medical management or other interventions.
  1. Unfavorable Anatomy: In some cases, the anatomy of the VSD may be unfavorable for surgical repair. For example, if the VSD is located in an area that is difficult to access or repair, or if there are associated complex heart defects that make surgical closure challenging, the surgical team may determine that VSD repair surgery is not feasible.