8th March 2024

Management

Asymptomatic patients with small defects do not require intervention apart from routine cardiology follow-up. The following indications warrant intervention with surgical or percutaneous closure: 

• Haemodynamically significant VSD in patients with evidence of LV dysfunction
• Prolapse of aortic valve causing moderate aortic regurgitation 
• In the presence of severe pulmonary hypertension, closure should only be considered in the case of left-to-right shunt (Qp:Qs ratio >1.5)
• Double chamber RV 
• Infective endocarditis

Surgical closure can be performed with low operative mortality and good long-term outcomes. Percutaneous closure can be considered in selected cases, such as muscular and membranous VSDs that are located away from the tricuspid and aortic valves.