What is VSD device closure?
A ventricular septal defect is a hole in the wall between the two lower, pumping chambers of the heart. It is the most common congenital heart defect, accounting for roughly a fifth of all cases.
Device closure seals the hole through a catheter rather than through open-heart surgery. A specially designed implant is carried to the defect through a blood vessel, deployed across the hole, and gradually covered by the child's own tissue.
Which VSDs can be closed with a device
The wall between the ventricles has several regions — membranous, inlet, muscular (trabecular) and outlet. Defects can occur singly in any of them, or as several holes in the muscular part.
Muscular VSDs are generally the most suitable for device closure. Closure is considered where the defect is causing a significant left-to-right shunt — meaning the heart and lungs are handling substantially more blood than they should — and the child is of adequate size, typically over about 5 kg.
Defects sitting close to the heart valves or the conduction system need particular caution and are often better repaired surgically. This is a decision that turns entirely on your child's individual anatomy.
Importantly, many small VSDs close by themselves during early childhood and need only observation.
What happens on the day
Under general anaesthesia, catheters are passed from the groin. The defect is measured and its relationship to the valves and the heart's electrical pathways carefully assessed. The device is positioned, checked, and released only when it is sitting correctly.
VSD closure is technically more demanding than ASD closure and generally takes longer — often two to three hours.
Recovery
Most children stay one to two nights. Rhythm monitoring afterwards is routine, because the conduction system runs close to some VSDs. Aspirin is usually given for around six months, with follow-up echos at set intervals.