Ventricular septal defect

Lancet. 2011 Mar 26;377(9771):1103-12. doi: 10.1016/S0140-6736(10)61339-6. Epub 2011 Feb 23.


Ventricular septal defects account for up to 40% of all congenital cardiac malformations. The diagnosis encompasses a broad range of anomalies, including isolated defects and those associated with other congenital cardiac malformations. Presentation, symptoms, natural history, and management of ventricular septal defects depend on size and anatomical associations of the anomaly, patient's age, and local diagnostic and interventional expertise. In this Seminar, we describe the anatomical range of ventricular septal defects and discuss present management of these malformations. Genetic determinants, diagnostic techniques, physiological considerations, and management challenges are examined in detail. Unfortunately, in many circumstances, evidence on which to guide optimum management is scarce. We present some longer term considerations of ventricular septal defects in adolescents and adults, with particular emphasis on patients with raised pulmonary vascular resistance and Eisenmenger's syndrome.

Publication types

  • Review

MeSH terms

  • Antibiotic Prophylaxis
  • Aortic Valve Insufficiency / physiopathology
  • Aortic Valve Insufficiency / surgery
  • Cardiac Volume / physiology
  • Cardiovascular Surgical Procedures
  • Coronary Circulation / physiology
  • Echocardiography
  • Eisenmenger Complex / diagnosis
  • Eisenmenger Complex / therapy
  • Endocarditis / prevention & control
  • Exercise Tolerance / physiology
  • Female
  • Heart Septal Defects, Ventricular / diagnosis*
  • Heart Septal Defects, Ventricular / etiology
  • Heart Septal Defects, Ventricular / physiopathology*
  • Heart Septal Defects, Ventricular / surgery
  • Humans
  • Hypertension, Pulmonary / physiopathology
  • Hypertrophy, Left Ventricular / physiopathology
  • Hypertrophy, Right Ventricular / physiopathology
  • Oral Hygiene
  • Pregnancy
  • Pregnancy Complications / physiopathology