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Suggest Treatment For Perimembranous Ventricular Septal Defects
Question: my baby saumya 4 month old she have 4 mm vsd preimbournous left to right shunt her weight 5kg her height 25 inch kindly suggest surgery required or not
Brief Answer:
Two alternatives wait and watch or device closure later after 1 year of age.
Detailed Answer:
Hello XXXXXXX I am Dr. Mody and I would be addressing your concern .
I went through the short description and the echo reports you have attached .
Two important aspects here which I would like to know further
1) Is your daughter having any symptoms, and which medication is she on , as she appears to have grown well (5 kg). So are there any recurrent lung infections , any failure to thrive, poor feeding .
2) A more detailed and recent echocardiography report as the report you have attached is nearly 3 months already (when the baby was 1.5 months)
Now if we go by statistics, perimembranous Vsd s , closure rate is 30-40 % (by 3 -4 years of age) as compared to other muscular vsd which may close by themselves in 80 -90% cases.
1) There is less (30%) but still a chance that it will close by the tricuspid leaflet ( which has already closed 2 mm of it)
2) If we can wait for her to grow;a little more with serial monitoring by keeping a tab on her growth rate, symptoms and echocardiography. Later it can be closed by an umbrella like device.
Lastly surgery is always an option in such cases
And it should be done at right time as once the lung pressure start rising it may become irreversible and surgery will not benefit so intervention at right time is the strategy here.
Do inform me about latest reports and her clinical condition.
Regards Dr. Priyank Mody, XXXXXXX
Two alternatives wait and watch or device closure later after 1 year of age.
Detailed Answer:
Hello XXXXXXX I am Dr. Mody and I would be addressing your concern .
I went through the short description and the echo reports you have attached .
Two important aspects here which I would like to know further
1) Is your daughter having any symptoms, and which medication is she on , as she appears to have grown well (5 kg). So are there any recurrent lung infections , any failure to thrive, poor feeding .
2) A more detailed and recent echocardiography report as the report you have attached is nearly 3 months already (when the baby was 1.5 months)
Now if we go by statistics, perimembranous Vsd s , closure rate is 30-40 % (by 3 -4 years of age) as compared to other muscular vsd which may close by themselves in 80 -90% cases.
1) There is less (30%) but still a chance that it will close by the tricuspid leaflet ( which has already closed 2 mm of it)
2) If we can wait for her to grow;a little more with serial monitoring by keeping a tab on her growth rate, symptoms and echocardiography. Later it can be closed by an umbrella like device.
Lastly surgery is always an option in such cases
And it should be done at right time as once the lung pressure start rising it may become irreversible and surgery will not benefit so intervention at right time is the strategy here.
Do inform me about latest reports and her clinical condition.
Regards Dr. Priyank Mody, XXXXXXX
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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