VSD Device Closure

Hemalatha R¹,*, Sheeba²

¹Nursing Supervisor, Kauvery Heartcity, Trichy, India

² Staff Nurse, Kauvery Heartcity, Trichy, India

*Correspondence: nursing.heartcity@kauveryhospital.com

Abstract

Ventricular Septal Defect (VSD) is the most common congenital cardiac anomaly in children and second most common congenital abnormality in adult, second only to a bicuspid Aortic Valve. Abnormal communication between the right and left ventricles and shunt formation is the main mechanism of hemodynamic compromise in VSD. Small VSDs may close spontaneously; when they do not, large defects can lead to complications such as pulmonary arterial hypertension (PAH), reversal of shunt which leads to a cyanotic heart disease (Eisenmenger’s Syndrome), and ventricular dysfunction with increased risk of arrhythmias, VSDs were first identified by Dalrymple in the year 1847.

The patient we describe here was a one-year-old boy. He was diagnosed with congenital acyanotic heart disease- 4mm perimembranous VSD. In view of the above findings the child was advised VSD closure.

Background

Patient was a baby, 1year old boy. He was diagnosed with congenital acyanotic heart disease- 4mm perimembranous VSD. In view of the above findings the patient was advised VSD closure.

Examination

CVSS1 S2	SAO2 100% RA
RSBAE (+)	BP 80/60
D/A-Soft	HR132b/m
CNSNFND	RR26bm
Temp	98.6 F

Investigation

Pre OP ECG: Left Ventricular Hypertrophy, by voltage criteria. Likely Rt Ventricular Hypertrophy.

Post OP ECG:

ECHO Report:

Provisional Diagnosis:

ACHD, VSD

Treatment:

“0” POD,

Inj. Glyco – 1CC

Inj. Ketamine – 1CC

Inj. Midaz – 1CC

Inj. Propofol – 1CC

Inj. Emeset – 1CC

Inj. Ceftriazone – 500mg

“1” POD

Tab. Aspirin – 75mg

Tab. Aldactone – 25mg

Syp. Faroped Drops – 0.5ml

Discharge Medication Advised:

Tab. Aspirin – 75mg

Diet Advice:

Normal diet

Nursing Management:

Patient was received from Cath lab to IV-GW continuous cardiac monitoring.
Nurses maintained an every 15mins check BP chart, BP was stabilized with inotropes and IV fluids.
Doctors explained the patient’s condition to the attenders; nurses obtained consent for the clinical procedure after proper counseling.
Nurses used AIDET techniques acknowledge, introducing, duration, explanation and thank you, while communicating with patient and attenders, to give their confidence and improve the satisfaction level.
Patient stabilized discharge followed as per doctor’s advice.

Outcome

On discharge, patient was hemodynamically stable.

Ms. R. Hemalatha,

Nursing Supervisor, Kauvery Heartcity

Ms. Sheeba

Staff Nurse, Kauvery Heartcity

VSD Device Closure