Ventricular Septal Defect (VSD)

A ventricular septal defect develops in the wall of tissue (septum) that divides the right ventricle and the left ventricle. A VSD is a common defect at birth (congenital). It can also occur as the result of a heart attack or after surgery.

When there is an opening between the right ventricle and left ventricle, oxygen-rich blood from the left ventricle mixes with blood that still needs to get oxygen from the lungs before it goes out to the body. A VSD makes your heart work harder to deliver oxygen-rich blood to support your body’s functions. This extra effort can enlarge and weaken the right side of your heart.

VSD Symptoms and Risks

Many individuals who have a VSD don’t know about it until they have an ultrasound for another medical condition. A small VSD may not cause any problems or require treatment. In fact, sometimes small VSDs eventually close without any treatment.

Adults who have lived with a VSD since birth and those who have developed a VSD as an adult may experience:
  • Fatigue or weakness
  • Shortness of breath — especially when active
  • Rapid or irregular heart beat
  • Heart murmur (an unusual sound between heart beats that may be due to a defect in the heart’s wall or a damaged valve)

A medium or large VSD may increase your risk for:

  • Endocarditis (an infection of the inner lining of the heart, the endocardium)
  • Pulmonary hypertension (high blood pressure in your lungs and right side of your heart)
  • Arrhythmia (irregular or abnormal heart beats)
  • Valve problems
  • Heart failure (a condition in which the heart can’t pump as well as it should, limiting the amount of blood available to support the body’s functions, also known as congestive heart failure)

If you have symptoms of a VSD, your primary-care provider may order an echocardiogram and refer you to the Structural Heart and Valve Disease team at the Swedish Heart & Vascular Institute (SHVI) for further evaluation.

Closing a VSD

The Structural Heart and Valve Disease team will use advanced imaging to confirm the diagnosis, evaluate the size and location of the VSD and various treatment options. If your VSD is small, your cardiologist may recommend monitoring your condition. If your symptoms are significant and the VSD is medium or large, your cardiologist will talk with you about procedures that are available at Swedish to close the opening.

Catheter-based procedure:
During this procedure, you will be under conscious (twilight) sedation. Using a local anesthetic, your cardiologist will make a small incision in your groin and then thread a catheter through a vein and up to your heart and the area where the hole is located. Your doctor will then use the catheter to deliver the closure device. Over time, your own tissue will grow over the device, making it permanent.

Before, during and after the procedure, your cardiologist will rely on advanced imaging to determine to location and size of the opening, as well as proper placement of the device. The closure procedure takes about one hour. Most patients remain overnight in the hospital after a VSD closure procedure.


Ventricular septal defect closure device.

Open-heart surgery: Often the most appropriate treatment is open-heart surgery, which is performed while you are under general anesthesia. The surgeon will make an incision in your chest and connect your heart to a heart-lung machine, so your blood will continue to circulate throughout the procedure. The surgeon will use a patch or stitches to close the hole in the septum. After surgery, patients typically spend two to three days in the hospital.

For more information about open-heart surgery to repair a ventricular septal defect, go to Swedish Cardiac Surgery>