Management of asymptomatic ventricular septal defect

A patient with a small ventricular septal defect should not be subjected to operative closure of the defect. Such a ventricular septal defect is characterized by a normal second sound, normal electrocardiorgram, normal thoracic roentgenogram and echocardiogram. If the patient is catheterised, the pulmonary and right ventricular pressures are normal and the pulmonary blood flow is less than twice the systemic blood flow. If left alone a patient with such a defect is not likely to develop any difficulty throughout his life because of the defect itself, however, a periodic assessment of the patient is necessary. The patient and the parents should be advised regarding prophylaxis against infective endocarditis.