Small ventricular septal defects which do not eventually close rarely cause any longer-term difficulties. However, depending on the location of the hole, lifelong follow-up may be required.
Children who have had their ventricular septal defects close on their own or closed completely at surgery do not need any medications, and should not be restricted in any way.
Unrepaired large ventricular septal defects and some moderate ventricular septal defects can cause two problems.
First, infants may have ongoing symptoms of congestive heart failure. Infants who have poor growth due to congestive heart failure can have poor brain development during the first few years of life. This is the time of most rapid brain development, therefore good nutrition is important for the development of the baby.
In addition, babies with congestive heart failure are at higher risk for infections, particularly lung infections. If they do get a lung infection, they may not tolerate it as well as other babies and can become very sick with even a simple winter cold. Immunizations may protect against some lung infections but not all, and complications from these infections can be life-threatening.
Secondly, as the lungs are exposed to excessive pressure and flow over a period of years the vessels in the lungs may react by developing thicker walls. The pressures in the lungs will then increase as a result.
The pressures in the lungs can become so high that blue blood from the right ventricle will flow across the ventricular septal defect into the left ventricle and mix with red blood.
The patient will then have less oxygen going to the rest of the body and will start to develop cyanosis. The high pressures in the lungs can initially be reversed, but with time will become irreversible and result in failure of the heart.
Techniques for diagnosis and treatment have become so sophisticated that this complication is extremely rare; although, there are older people who are alive today in the United States who have unrepaired ventricular septal defects.
This is more of a concern in underdeveloped countries where resources or easy access to health care are limited and large ventricular septal defects may go undiagnosed and untreated.
If large ventricular septal defects are diagnosed and managed appropriately, this will never happen and a child with a ventricular septal defect can have a normal length of life with no restrictions.