It is commonest cardiac malformation at birth (1 in 500 live births.)
Due to defect in the ventricular septum blood from the left ventricle (which is a high pressure chamber) goes to the right ventricle (which is a low pressure chamber). Thus left atrium and both ventricles are hypertrophied and pulmonary hypertension soon develops. In course of time the direction of shunt is reversed, called Eisenmenger’s complex.Small defect is called Maladic de Roger.
VSD may be acquired from trauma or septal infraction.
By one heart surgery or by-pass techniques this defect can be repaired. When the defect is small no operation is needed. Sometimes small defect may close spontaneously (<10%). In presence of increased pulmonary vascular resistance operation is contraindicated. Surgical mortality is 2-5% for primary repair.
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