What to do if premature babies have ventricular septal defect

Infants have many congenital diseases in their early years, especially in the heart. There are many types of congenital heart diseases, such as arrhythmia, premature beats, heart damage, etc., which are all types of heart disease. The intraventricular septal defect of premature babies is also a type of heart disease. Faced with this disease, people can't even finish the name, and they are definitely not clear about how to treat this disease. So what should be done with the intraventricular septal defect of this premature baby?

1. Medication

Small defects do not require treatment. However, antibiotic prophylaxis is indicated before dental or other invasive procedures that may result in transient bacteremia to avoid bacterial endocarditis. Infants with moderate to large left-to-right shunts who develop heart failure may also be treated initially with drugs when spontaneous closure of the defect, either partial or complete, is likely:

(1) Diuretics reduce cardiac workload and systemic venous congestion. Spironolactone (spironolactone) has a potassium-sparing effect. When furosemide and spironolactone (spironolactone) are used simultaneously, no additional potassium supplementation is required.

(2) Digoxin is generally not used when young infants first experience an increase in stress.

(3) Vasodilators such as enalapril and captopril can effectively reduce systemic circulatory overload. During long-term use of these drugs, blood electrolytes, digoxin levels, and renal function should be checked regularly. When medical treatment is ineffective, surgical treatment may be indicated as soon as possible.

2. Surgical treatment

(1) Indications for surgery: patients with simple ventricular septal defect without other malformations, heart failure that cannot be controlled by medication, large left-to-right shunt, limited movement and poor response, and pulmonary hypertension with recurrent lung infections. If the pulmonary:aortic blood flow is greater than 2, it means that there is at least a medium-sized defect and surgery is required to close the gap; if the ratio is less than 2:1, pulmonary hypertension will not occur and it is generally treated with medication first. After 1 to 2 years of age, cardiac catheterization is repeated to understand changes in left-to-right shunt volume and pulmonary vascular resistance. If the pulmonary artery pressure of a 5- to 6-year-old child continues to be 50% higher than the aorta, surgery is also required to reduce the occurrence of pulmonary vascular disease. Most patients undergo surgery between 3 and 12 months of age. Pulmonary artery pressure can return to normal after ventricular septal defect repair at this age. At the Cardiovascular Center, the mortality rate among infants undergoing surgical repair of ventricular septal defects is now close to zero.

(2) Early postoperative complications include low outflow tract syndrome, complete heart block, and pulmonary hypertension crisis caused by ventricular dysfunction.

This type of intraventricular septal defect in premature babies can be treated with these methods. First, the child should be given diuretics to help the child urinate. Then the child's vascular abnormalities should be controlled and the child's blood vessels should be actively dilated. When the child's body is normal and there is no obstruction to renal function, then the child can be considered for surgical treatment.