Ventricular Septal Defect

What is ventricular septal defect?

Babies born with ventricular (pronounced ven-TRIH-ku-lar) septal defect (VSD) have a hole in the wall of their heart between the 2 lower chambers (right and left ventricles) where the blood leaves the heart. This wall is the ventricular septum.

Blood comes from the body into the right atrium. Then it flows into the right ventricle. The right ventricle pumps it to the lungs to get oxygen. Next, blood travels from the lungs to the left atrium. Then it flows into the left ventricle, which pumps it out to the rest of the body.

Normally, blood cannot pass between the ventricles. But when there is a hole between the sides of the heart, some oxygen-rich blood leaks from the left ventricle into the right ventricle and goes back to the lungs.

The hole may be small and cause no symptoms, or it may be large and cause serious problems with blood flow. If the hole is large, too much blood will be pumped to the lungs, leading to congestive heart failure.

Also, the heart will have to work harder to pump blood to the body. As a result of the extra work, the heart can get bigger.

  • VSD is the most common heart birth defect. About 3 in every 1,000 babies have it.

    VSD is often referred to as a hole in the heart. It happens early in the baby’s development when the heart is forming.

    Some children with VSD have other heart defects, like atrial septal defect. Some have other genetic conditions that increase the risk for VSD, like Down syndrome.

Ventricular Septal Defect at Seattle Children’s

Consistently ranked one of the nation's best cardiology and cardiac surgery programs by U.S. News and World Report.

  • With more than 40 pediatric cardiologists, we have experience diagnosing and treating every kind of heart problem.

    Our heart team has extensive experience with the treatments patients may require for VSD, including: 

    We also have a pediatric cardiac anesthesia team and a Cardiac Intensive Care Unit ready to care for children who undergo heart surgery.

    See our statistics and outcomes for ventricular septal defect repair.

    Seattle Children’s has been treating children since 1907. Our team members are experts in their fields and in meeting the unique needs of children. For example, the doctors who give your child anesthesia (sedation) are board certified in pediatric anesthesiology. This means they have extra years of training in how to take care of kids. Our child life specialists know how to help children understand their illnesses and treatments in ways that make sense for their age.

  • When you come to Seattle Children’s, a team of people will take care of your child. Along with your child’s heart doctor (cardiologist), you are connected with other providers, such as neonatologists, lung doctors (pulmonologists), nurses, child life specialists, social workers and others, if their expertise is needed.

    We work together to meet all of your child’s health needs and help your family through this experience. We’ll discuss treatments in ways you can understand and involve you in every decision.

    Read more about the supportive care we offer.

    The Adult Congenital Heart Disease Program shared by Seattle Children’s and the University of Washington can help with care throughout your child’s life.

Symptoms of Ventricular Septal Defect

A small VSD may cause no symptoms at all. A larger defect may cause symptoms soon after birth.

Children may have symptoms like these: 

  • Fast breathing or working hard to breathe
  • Arrhythmia
  • Frequent respiratory infections
  • Trouble eating or gaining weight (failure to thrive)
  • Pale skin 

Large defects that aren’t treated can increase the risk for certain heart or blood problems later in life, like high blood pressure in the lungs.

Diagnosing Ventricular Septal Defect

To diagnose this condition, your doctor will examine your child, check their heartbeat and use a stethoscope to listen to their heart. In children with VSD, doctors can often hear a heart murmur.

The doctor will ask for details about your child’s symptoms, their health history and your family health history.

Your child will most likely need echocardiography and electrocardiogram.

They may need other tests that provide more information about how their heart looks and works. These include chest X-raysor MRI (magnetic resonance imaging) of the heart, angiography and cardiac catheterization.

Treating Ventricular Septal Defect

Your child may not need any treatment for VSD. In some children, it does not cause any problems. Or, if the hole is small, it may close up on its own as your child grows. So your doctor may simply recommend monitoring your child’s condition.

Some children do need treatment because the defect causes troubling or serious symptoms.

  • Some VSDs are treated using a long, thin tube (catheter) to place a device in the heart that closes the hole in the septum. This is called cardiac catheterization. Other patients need surgery to close the hole with stitches or a patch and get the blood to circulate the correct way.

    The position and size of the defect are important factors in deciding which treatment to use. If the defect is large and close to a heart valve, doctors may not be able to close it using a catheter; instead, the child will need surgery. Also, children need to reach a certain age and weight in order to have catheterization.

    Some children who are too young or small for typical catheterization may be able to have a hybrid procedure to avoid open-heart surgery. A cardiac surgeon and a cardiologist work together to place the closure device by putting a catheter through the wall of the heart.

Helping Your Child Transition to Adult Care

To meet your child’s long-term healthcare needs, we have a special Adult Congenital Heart Disease Program to transition your child to adult care when they’re ready.

Contact Us 

Contact the Heart Center at 206-987-2515 to request an appointment, a second opinion or more information.

Providers, see how to refer a patient.