Narrow ventricular septal defect (VSD type I), which protects the pulmonary vasculature. There are no functional symptoms. Cardiac auscultation reveals a harsh mesocardiac mesosystolic murmur, (4th intercostal space, radiating radially; S2 is normal). The size of the heart is normal and ECG is normal. The diagnosis is echocardiographic. The usual evolution is spontaneous closure before the age of 3 (the VSD sometimes persists for up to 15 years). There is no surgical indication, no antibiotic prophylaxis of endocarditis is required.

Anesthetic implications:

VSD management without pulmonary hypervascularisation.

References : 

• Miyate T, Shinohzara T, Fukuda T et al. 
  Spontaneous closure of ventricular septal defects followed up from < 3 months of age.
  Pediatr Int 2004; 46: 135-40.

Updated: October 2018