Chapter 4 - Ventricular septal defects (VSDs)

Abstract

Ventricular septal defects are defects of the interventricular septum. The most common type is a perimembranous ventricular septal defect, affecting the membranous septum and the surrounding muscular septum. In a subarterial ventricular septal defect (or doubly committed ventricular septal defect), the infundibular septum is absent. In a malalignment ventricular septal defect, there is a lack of alignment between the infundibular and the trabecular septum. Muscular ventricular septal defects affect various parts of the muscular septum. In extreme cases, the interventricular septum has a “Swiss cheese” appearance. Significant left-to-right shunt at the ventricular level leads to left heart volume overload, excessive pulmonary blood flow, and progressive development of pulmonary hypertension. The treatment of ventricular septal defects consists of surgical or transcatheter closure. Palliative pulmonary artery banding is performed in selected cases.