A ventricular septal defect (VSD) is a defect in the interventricular septum allowing a haemodynamic communication between the right and left ventricles. It typically results in a left to right shunt.
They represent one of the most common congenital cardiac anomalies and may be associated with up to 40% of such anomalies 1. The estimated incidence is at ~ 1 in 400 births 6.
Classification according to location
- membranous / perimembranous (most common : ~ 80 - 90%)
- muscular / trabecular
A VSD can occur on its own but frequently tends to occur with other cardiovascular associations.
- cardiovascular associations
- extra cardiac associations
CXR can be normal with a small VSD. Larger VSDs may show cardiomegaly (particularly left atrial enlargement although the right and left ventricle can also be enlarged). A large VSD may also show features of pulmonary oedema, pleural effusion or / and increased pulmonary vascular markings.
Ultrasound - echocardiography
Allows direct visualisation of the septal defect which can be easily seen in the four chamber view. A perimembranous VSD can seen as a septal dropout in the area adjacent to the tricuspid septal leaflet and below the right border of the aortic annulus. Small isolated VSD's can be difficult to detect prenatally.
Allows direct visualisation of the defect on contrast CT.
May also show added functional information (e.g. quantifiation / shunt severity) in addition to anatomy. Some muscular defects can give a "Swiss cheese" appearance owing to their complexity.
The prognosis is good for small VSDs which show a high spontaneous intra-uterine or post-natal closure rate. VSD's usually do not cause any haemodynamic compromise in utero due to right and left ventricular pressures being very similar during that period.
- 1. Barboza JM, Dajani NK, Glenn LG et-al. Prenatal diagnosis of congenital cardiac anomalies: a practical approach using two basic views. Radiographics. 22 (5): 1125-37. Radiographics (full text) - Pubmed citation
- 2. Kellenberger CJ, Yoo SJ, Büchel ER. Cardiovascular MR imaging in neonates and infants with congenital heart disease. Radiographics. 27 (1): 5-18. doi:10.1148/rg.271065027 - Pubmed citation
- 3. Sechtem U, Pflugfelder P, Cassidy MC et-al. Ventricular septal defect: visualization of shunt flow and determination of shunt size by cine MR imaging. AJR Am J Roentgenol. 1987;149 (4): 689-92. AJR Am J Roentgenol (abstract) - Pubmed citation
- 4. Jaffe RB, Scherer JS. Supracristal ventricular septal defects: spectrum of associated lesions and complications. AJR Am J Roentgenol. 1977;128 (4): 629-37. AJR Am J Roentgenol (abstract) - Pubmed citation
- 5. Wang ZJ, Reddy GP, Gotway MB et-al. Cardiovascular shunts: MR imaging evaluation. Radiographics. 2003;23 Spec No : S181-94. doi:10.1148/rg.23si035503 - Pubmed citation
- 6. Goo HW, Park IS, Ko JK et-al. CT of congenital heart disease: normal anatomy and typical pathologic conditions. Radiographics. 2003;23 Spec No : S147-65. doi:10.1148/rg.23si035501 - Pubmed citation
- 7. Entezami M, Albig M, Knoll U et-al. Ultrasound Diagnosis of Fetal Anomalies. Thieme. (2003) ISBN:1588902129. Read it at Google Books - Find it at Amazon
- 7. Bahtiyar MO, Dulay AT, Weeks BP et-al. Prenatal course of isolated muscular ventricular septal defects diagnosed only by color Doppler sonography: single-institution experience. J Ultrasound Med. 2008;27 (5): 715-20. J Ultrasound Med (full text) - Pubmed citation
- 8. Axt-fliedner R, Schwarze A, Smrcek J et-al. Isolated ventricular septal defects detected by color Doppler imaging: evolution during fetal and first year of postnatal life. Ultrasound Obstet Gynecol. 2006;27 (3): 266-73. doi:10.1002/uog.2716 - Pubmed citation
Synonyms & Alternative Spellings
|Synonyms or Alternative Spelling||Include in Listings?|
|Ventricular septal defect||✓|
|Ventricular septal defect (VSD)||✗|
|Ventricular septal defects||✗|