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Ventricular Septal Defect — RACP Paediatrics MCQ

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HardCardiologyVentricular Septal DefectRACP Paediatrics

A 6-month-old infant with a large unrepaired VSD presents with tachypnoea, hepatomegaly, and failure to thrive. Weight is on the 3rd centile, having been on the 50th centile at birth. Medical management with diuretics and captopril has been optimised. What is the most appropriate next step?

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Correct answer: B — Surgical VSD closure

A large VSD with failure to thrive despite maximal medical therapy is an indication for definitive surgical repair. Surgical closure of the VSD is preferred over PA banding in most centres. Delaying repair risks irreversible pulmonary vascular disease (Eisenmenger syndrome). Cardiac catheterisation is generally not required before surgical repair of a straightforward large VSD.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Ventricular Septal Defect