this ppt is made by sandeep sengar

1. PRESENTED BY :-
SANDEEP SENGAR
VENTRICULAR
SEPTAL DEFECT

2. Ventricular septal defect (VSD), is a hole between
your heart’s lower chambers, or ventricles that allow
shunting of blood between the left and the right
ventricles. The defect can occur anywhere in the
muscle that divides the two sides of the heart. It is
most common congenital cardiac anomaly in
children and is the second most common congenital
abnormality in adults.

3. Types
Of
VSD
MUSCULA
R
VSD
CONAL
SEPTAL
VSD
PERI
MEMBRANO
US
VSD
ATRIO
VENTRICUL
R
CANAL
VSD

4. ACQUIREDCONGENITAL
CAUSE
Congenital heart
defect ,present
at birth can be
see nearly 2 per
1000 live births.
1 Chest Trauma
2 Myocardial
Infection
Well known
cause

5. VSD In 2D Echo
The VSD may be small or large in size and single or multiple. The
septal defect may be in the upper membranous portion (base) or in
the lower muscular septum (apex).
An infundibular (supracristal) VSD is located below the pulmonary
valve (subpulmonary). An atrioventricular defect is located in the
posterior portion of the septum around the tricuspid valve.
An infundibular (supracristal) VSD is located below the
pulmonary valve (subpulmonary). An atrioventricular defect is
located in the posterior portion of the septum around the
tricuspid valve.
2
3
1

6. No echo drop-out is observed if the defect is too small (<
3 mm) in size. If it is muscular in location, which shuts off
during contraction in systole.
4
5 Multiple and small defects give the septum a “sieve-like” Or
“Swiss-cheese” appearance.

7. VSD In Doppler Echo
On color flow mapping, there is an abnormal flow pattern
from the left to right ventricle The width of the color flow map
approximates the size of The defect and helps in quantitative
assessment.
On continuous wave (CW) Doppler, a high velocity jet is
identified across the septal defect High velocity jet with a high
pressure gradient is suggestive of a small restrictive VSD in
the muscular portion.
With a significant volume of left-to-right shunt, there are
features of right ventricular volume overload such as right
ventricular dilatation beyond 23 mm and paradoxical motion
of the IV septum.
1
3
2

8. Doppler Calculation
The pulmonary artery pressure can be estimated from the
transtricuspid peak flow velocity and pulmonary hypertension
can be identified (see Pulmonary Hypertension).
The quantity of left-to-right shunt can be estimated from the
ratio between pulmonary and systemic stroke volume, which
is the Qp : Qs ratio
Qs is aortic outflow and Qp is pulmonary outflow. Qp is
greater than Qs since a portion of the left ventricular output
goes to the right ventricle
1
2
3

9. Cath Procedure Summary
AMPLATZER® Duct Occluder Device used for VSD
On the day of the procedure, pediatric cardiac anesthesiologist
will place patient under sedation. He or she will be asleep during
the procedure and not feel any pain. The anesthesiologist
continues to monitor your child the entire time
During the procedure
Insert a catheter (a long, thin tube) into a blood vessel near your
patient groin.
Measure pressure and oxygen in heart and size of opening.2
Place the occluder onto a special catheter and advance it to the VSD
opening in the patient heart.
1
3

10. Push the device out of catheter and implant it over
the opening. The device fills the opening and seals it
closed.
Remove the catheter and close the incision.
Transfer patient to Cardiac Procedure Recovery Unit
(CPRU) ,patient will need to stay overnight in the
hospital after the procedure.
Patient will be transferred to the inpatient unit from the
recovery room. Cardiologist do an echocardiogram the next
morning to check the placement of the device.
4
6
5
7
The cardiologist will let you know when the patient can go
home.
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11. RISK
01
02
03
04 There is a small risk of heart
rhythm problems
Complications may occur with
the closure device
The catheter may break
through a blood vessel
INFECTIO
N

12. Thanks