Physicians may wish to wait long enough to see if the ventricular septal defect (VSD) will close on its own, particularly if it is a membranous VSD (which has the highest chance of self-closing). A VSD that does not close on its own after birth will need treatment. The physician may wish to try to treat the VSD with medications, which may include the following:

If the medications are not working, or the VSD is too large, or the child has already passed the age at which the VSD would have closed, the physician will often choose to do surgery. Most often this surgery involves a sternotomy, an operation in which the breastbone (sternum) is divided in two to open the chest and expose the heart. The strategy for closing a defect during surgery depends on the size of the hole and its location. Smaller holes are closed by stitches (sutures). Larger holes are patched with a large “swatch” made of either a synthetic material or the patient’s own tissue (often from the fluid–filled sac around the heart called the pericardium). When a VSD occurs along with other defects, the surgery becomes more complicated. However, the surgery to treat a VSD alone has a relatively low risk, high rate of success and short hospital stay (three to five days).

Minimally invasive techniques are being tested to repair septal defects. Researchers are evaluating a method to squeeze a patch into a catheter and snake it through the body up to the heart. Once in place, the physician can place the patch over the hole, sealing it. The patch eventually becomes covered with the body’s tissues. Catheter closure of VSDs are limited by the nature of individual VSDs. If, for example, the VSD involves the heart valves, it may not be possible to access the defect without causing damage to structures associated with the valves.