Can a ventricular septal defect heal by itself?

Written by Chen Tian Hua
Cardiology
Updated on November 16, 2024
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Some ventricular septal defects can heal on their own. For ventricular septal defects smaller than five millimeters, some patients can heal on their own; the defects that generally heal are those in the membranous and muscular parts of the septum, and the younger the age, the greater the likelihood of healing. If the ventricular septal defect still exists after the age of five, it generally cannot heal on its own. For ventricular septal defects that do not heal spontaneously, if they significantly affect hemodynamics, interventional treatment or surgical surgery is needed for repair. If the impact of the ventricular septal defect on hemodynamics is not significant, regular follow-up examinations can be conducted to understand the condition of the disease.

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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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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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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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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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What should I do about hypoxia due to a ventricular septal defect?

Mild ventricular septal defects generally do not cause hypoxia. If symptoms of hypoxia recur due to a ventricular septal defect, it is recommended to undergo minimally invasive interventional treatment or surgical treatment at a hospital to prevent further episodes. The success rate of this surgery is very high, almost 100%, with relatively few complications. If hypoxia occurs in untreated ventricular septal defects, initial therapy should include oxygen administration, followed by diuretic, cardiotonic, and other treatments to reduce cardiac load at a hospital, and surgery should be considered as soon as suitable.