Skilled Care for a Serious Heart Defect
Ventricular
septal defect (VSD) refers to one or more holes in the muscular wall that
separates the heart’s left and right ventricles. The holes allow too much blood
to flow to the lungs, which can lead to heart
failure.
Although VSD
is among the most common congenital heart defects, it also can occur after a heart attack in adults. It is corrected with open-heart
surgery.
UT
Southwestern’s experienced cardiologists and cardiothoracic surgeons expertly
diagnose and treat each patient’s unique case. Our specialized team offers the
most advanced technologies and surgical interventions for this serious
condition.
UT
Southwestern is also home to a dedicated Cardiac Rehabilitation Program. Cardiac rehabilitation is a
critical component of recovery and can prevent future heart disease.
What to Expect
VSD Repair: Preoperative Details
The surgeon provides specific instructions to the patient prior to the VSD
repair procedure, discussing risks such as bleeding, infection, or adverse
reaction to anesthesia.
Patients also meet with the anesthesiologist prior to the surgery to review
their medical history. Patients should not eat after midnight the night before
the surgery.
On the day of surgery, the patient arrives at the hospital, registers, and
changes into a hospital gown. A nurse reviews the patient’s charts to make sure
there are no problems.
The anesthesiologist then starts an IV, and the patient is taken to the operating
room, where the surgeon verifies the patient’s name and procedure before any
medication is given. Surgery will begin once the patient is under anesthesia.
For pediatric patients: Children
must be free from infection – including dental infections – for up to six weeks
prior to surgery. Please be sure children’s immunization records are made
available to the surgeon or nurse.
VSD Repair: Operative Details
Before the surgery begins, a cardiologist starts a transesophageal
echocardiogram (TEE) so the surgeon can look at the heart structure during surgery.
The surgeon then makes an incision in the breastbone to reach the heart,
and the patient is placed on a cardiopulmonary bypass machine – which pumps
blood to the body, bypassing the heart and lungs except for the coronary
arteries – while the heart is stopped temporarily.
The surgeon then makes an incision in either the right atrium, the pulmonary
artery, or the right ventricular outflow tract to access the defect. A patch – either
synthetic or made from the patient’s own pericardial tissue – is then stitched
onto the VSD to close it.
The heart is closed with sutures, and the cardiopulmonary bypass machine is
removed. Pacing wires are placed temporarily on the heart to prevent heart
rhythm abnormalities after the operation. Chest tubes are placed to collect
residual blood or fluid in the chest after the surgery, and the skin is closed
with stitches or staples.
VSD Repair: Postoperative Details
After surgery, patients are taken to the intensive care unit and monitored.
Pain is likely, and pain medication is given as appropriate. Patients also are
on a respirator and have a breathing tube for the first few hours after
surgery.
The length of the hospital stay depends on how quickly patients recover and
can perform some physical activity.
Support Services
UT
Southwestern’s cardiac rehabilitation specialists create customized plans that
integrate proper nutrition, exercise, and, if necessary,
nicotine cessation into patients’ lifestyles to improve their
cardiovascular health.
Clinical
Trials
As one of the nation’s top academic medical centers, UT Southwestern offers a
number of
clinical trials aimed at improving the outcomes of patients with
cardiovascular disease.
Clinical
trials often give patients access to leading-edge treatments that are not yet
widely available. Eligible patients who choose to participate in one of UT
Southwestern’s clinical trials might receive treatments years before they are
available to the public.