Christopher’s Journey.

Ventricular Septal Defect (VSD)

The most common heart defect (”Hole in the heart”). When small, such defects cause little in the way of problems and often “heal” (close) on their own. Blood flows from left ventricle to right ventricle at high pressure, often producing a loud “murmur” with each heart beat. The effect on heart function depends on the size of the defect, but may be very minor. Surgery may not be required, if the heart shows no evidence of “strain”.

Larger VSDs allow more blood to flow from the left ventricle to the right ventricle and lead to increase in pressure and flow in the lung circulation. This places significant strain on the heart and affected babies usually need surgical repair of the defect. An operation may be required in the first three to four months of life, though some defects, which are causing less trouble, may be left for a few years, in the hope that they may get smaller, only needing surgery if they remain large or are associated with other problems.

Transposition of the Great Arteries

The Aorta arises from the right ventricle and receives “blue” blood, whilst the Pulmonary Artery arises from the left ventricle. The baby becomes blue immediately after birth and needs urgent treatment. Survival depends on the ductus or the Foramen Ovale remaining open in the early days of life until treatment can be applied. The Foramen Ovale can be enlarged with a catheter procedure, called Balloon Septostomy, which is performed in the first few days of life. This involves a catheter with a balloon at the tip, which is passed from a leg vein until the balloon is in the left atrium (across the Foramen Ovale). The balloon is then inflated and the catheter is pulled back to the right atrium.

Early surgery is essential and involves the ” Arterial Switch Operation”, which is carried out in the first week or two of life and corrects the abnormality. The small coronary arteries, which feed the heart muscle with blood, need to be transferred as well as the two Great Arteries (Aorta and Pulmonary Artery).

Double Outlet Right Ventricle

In ‘Double Outlet Right Ventricle’ (DORV) the two Great Arteries (Aorta and Pulmonary Artery) both originate from the right ventricle and blood from the left ventricle passes across a VSD into the RV to reach the great arteries. The lung circulation is often exposed to very high pressure and increased blood flow (as with a large VSD). There are many different varieties of this abnormality.