VENTRICULAR SEPTAL DEFECT: A COMPREHENSIVE LITERATURE REVIEW OF PATHOPHYSIOLOGY, DIAGNOSIS, AND TREATMENT

Wiktoria Szumlińska; Julia Procyk; Marta Danuta Cendrowska; Aleksandra Klukowska; Beata Choromańska; Karolina Stępień; Justyna Berent; Paulina Rzepa; Barbara Ponitka; Julia Maszewska; Szymon Milnerowicz; Łukasz Brzost

doi:10.31435/ijitss.4(48).2025.4296

Wiktoria Szumlińska National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland https://orcid.org/0009-0001-5286-4228
Julia Procyk University Clinical Hospital in Wrocław, Wrocław, Poland https://orcid.org/0009-0009-7271-7047
Marta Danuta Cendrowska National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland https://orcid.org/0009-0008-0534-5995
Aleksandra Klukowska Military Institute of Medicine, Warsaw, Poland https://orcid.org/0009-0001-0064-3829
Beata Choromańska Mazovian Brodnowski Hospital, Warsaw, Poland https://orcid.org/0009-0009-1771-4265
Karolina Stępień Private Practice, Warsaw, Poland https://orcid.org/0009-0002-6812-5662
Justyna Berent District Hospital in Garwolin, Garwolin, Poland https://orcid.org/0009-0009-7378-556X
Paulina Rzepa Provincial Integrated Hospital in Elbląg, Elbląg, Poland https://orcid.org/0009-0005-4497-0230
Barbara Ponitka Lower Silesian Oncology Center, Wroclaw, Poland https://orcid.org/0009-0000-9077-9123
Julia Maszewska Lower Silesian Oncology Center, Wroclaw, Poland https://orcid.org/0009-0007-0788-9470
Szymon Milnerowicz Lower Silesian Oncology Center, Wroclaw, Poland https://orcid.org/0009-0004-5718-2367
Łukasz Brzost District Hospital in Garwolin, Garwolin, Poland https://orcid.org/0009-0003-4119-6679

DOI: https://doi.org/10.31435/ijitss.4(48).2025.4296

Keywords: Heart Septal Defects, Ventricular, Pulmonary Hypertension, Echocardiography, Cardiac Catheterization, Transcatheter Closure

Abstract

Background: Ventricular septal defect (VSD) is the most prevalent congenital heart defect, characterized by an abnormal communication between the ventricles, leading to a left-to-right shunt. Its clinical spectrum ranges from asymptomatic small defects to large shunts causing heart failure, pulmonary hypertension, or Eisenmenger syndrome. Early diagnosis and appropriate management are critical to prevent long-term complications.

Methods: This literature review synthesizes current evidence on the classification, pathophysiology, diagnostic modalities, treatment options, and long-term outcomes of VSD. A comprehensive analysis of peer-reviewed articles and clinical guidelines was conducted to present up-to-date insights into the multidisciplinary approach to VSD care.

Results: Anatomical subtypes of VSD vary in clinical significance, risk of complications, and management strategies. Advances in imaging, particularly echocardiography and cardiac MRI, have improved diagnostic precision. While small defects often resolve spontaneously and are managed conservatively, large or symptomatic defects may require surgical or transcatheter closure. Surgical repair remains the standard for most cases, but selected muscular and perimembranous defects can be treated percutaneously. Long-term follow-up is essential due to risks of arrhythmias, conduction block, residual shunts, or valve dysfunction. Emerging technologies—including biodegradable devices, minimally invasive surgery, and experimental gene therapy—may reshape future management paradigms.

Conclusions: VSD management requires individualized, anatomy-guided decision-making supported by multidisciplinary expertise. Technological progress has expanded therapeutic options, yet lifelong surveillance remains necessary to mitigate late complications and optimize outcomes.

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VENTRICULAR SEPTAL DEFECT: A COMPREHENSIVE LITERATURE REVIEW OF PATHOPHYSIOLOGY, DIAGNOSIS, AND TREATMENT

Abstract

References

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