Prof. Dr. Ali Serdar Fak
Cardiac SurgeryVerified
- 29+years exp.
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Congenital Heart Disease
Interventricular septal defect surgery
What a ventricular septal defect is, when interventricular septal defect surgery is needed and when watchful waiting is enough, how patch repair and catheter device closure differ, approximate costs in Turkey against the UK, US and Germany, what the hospital stay and recovery involve for children and adults, risks and how to choose a congenital heart centre.
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Dr. Bülent İlçöl
Cardiac SurgeryVerified
- 25+years exp.
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Interventricular septal defect surgery in Turkey: what it is and how it works
Interventricular septal defect surgery closes a hole in the wall (septum) between the two lower chambers of the heart. This hole, called a ventricular septal defect or VSD, is one of the most common congenital heart conditions. Normally the left ventricle pumps oxygen-rich blood to the body and the right ventricle sends blood to the lungs. A VSD lets blood leak from the high-pressure left side into the right side, so the lungs receive too much blood and the heart works harder. Closing the hole, either with a stitched patch during open-heart surgery or with a device placed through a catheter, restores a normal circulation.
Many VSDs are small and need no operation. This guide explains which ones do, how the surgery is done, what it costs in Turkey compared with the UK, US and Germany, what recovery involves for a child or an adult and how to check a congenital heart centre. Our overview of cardiology and heart surgery in Turkey shows the wider range of cardiac care.
Does every ventricular septal defect need surgery?
No. Small defects, especially in the muscular part of the septum, often narrow or close on their own during the first years of life, and a child with a small VSD can be monitored with check-ups and heart scans. The British Heart Foundation and paediatric cardiology societies describe surgery or device closure as appropriate when the hole is large enough to cause symptoms or raise pressure in the lung vessels.
Closure is generally advised when there is heart failure in infancy (fast breathing, sweating during feeds, poor weight gain), a moderate or large shunt that enlarges the left heart, rising pulmonary pressure, a valve problem such as the aortic valve slipping into the hole, or a history of endocarditis. A cardiologist decides this from the echocardiogram (see echocardiography) and sometimes a catheter study or MRI.
What types of VSD are there, and why does the type matter?
The location of the hole decides how it behaves and which repair is possible.
- Perimembranous: the most common type, near the heart valves. It can be closed by patch or in selected cases by device.
- Muscular: in the thick muscle of the septum; may close by itself, and large or multiple holes may suit a device.
- Subarterial (outlet): beneath the aortic and pulmonary valves; rarely closes by itself and carries a higher risk of aortic valve leakage, so surgery is more often advised.
- Inlet: near the tricuspid and mitral valves; usually closed by patch.
A defect that is part of a wider malformation is treated as a congenital heart surgery problem; see congenital heart surgery for the broader picture.
How is interventricular septal defect surgery performed, step by step?
For surgical repair the child or adult is under general anaesthesia. The surgeon opens the chest through the breastbone (sternotomy) or, in some centres, a smaller incision, connects the heart-lung machine, briefly stops the heart with a cooling solution and reaches the hole, usually through the right atrium. The defect is closed with a patch of Dacron or pericardium sewn into place, and the heart is restarted and checked on echocardiography before the chest is closed. The operation takes about three to five hours.
After surgery the patient goes to the intensive care unit for one to two days, with a breathing tube removed within hours in most uncomplicated cases, chest drains for two to three days and a monitoring line. A ward stay of about five to eight days follows.
Surgery or catheter device closure: which is used?
Some VSDs can be closed without opening the chest. A device is guided through a vein or artery in the groin and released across the hole. The table sets out the main differences.
| Method | Best suited to | Typical limits |
|---|---|---|
| Patch closure (open-heart surgery) | Most perimembranous, subarterial and inlet defects; large holes in infants | Heart-lung machine and chest scar; longer recovery |
| Catheter device closure | Selected muscular and some perimembranous defects with suitable edges | Not for holes near valves; risk of heart block and device-related problems |
| Watchful waiting | Small defects without symptoms or heart enlargement | Needs regular follow-up; rare complications such as endocarditis |
A related condition is a hole between the upper chambers, discussed in our guide to atrial septal defect surgery. Choosing the method requires an experienced congenital team and detailed imaging, so be cautious of any provider who quotes before seeing your scans.
What does interventricular septal defect surgery cost in Turkey compared with the UK, US and Germany?
The ranges are approximate for the complete episode of care, not hospital quotes. The type of defect, age and complexity change the price a great deal, and each hospital confirms its price in a written quote.
| Country | Approximate cost range |
|---|---|
| Turkey | €9,000 – €25,000 |
| United Kingdom | €20,000 – €45,000 |
| United States | €50,000 – €150,000 |
| Germany | €25,000 – €55,000 |
What changes the price: surgery versus catheter closure, the child's weight and the complexity of the defect, the length of intensive care and ward stay, any extra procedure such as aortic valve repair and the pre-operative tests. A package usually includes the consultation, imaging, surgery, anaesthesia, perfusion team, intensive care, ward stay, medication and transfers; check whether accommodation for a parent and a post-discharge echocardiogram are included.
Is VSD closure only for children?
Most VSDs are repaired in infancy or early childhood, often between three months and two years if a large hole is causing symptoms. Adults can have closure too: a defect found late, a moderate hole with a heart enlarged by the shunt or a previous infection may still be closed. In adults with long-standing high lung pressure (Eisenmenger syndrome) the hole usually cannot be closed safely, which is why timing matters. Whatever the age, a congenital heart cardiologist should review the echocardiogram and any catheter data before a plan is made.
Your trip to Turkey and recovery step by step
Allow about two to three weeks in Turkey for open-heart repair: a few days of pre-operative tests, intensive care and ward stay of roughly one week, then a check-up and echocardiogram before the flight home. After catheter closure the hospital stay is shorter, often two to three days, with a shorter overall trip. Infants recover quickly; most feed normally again within days. Older children and adults usually need two to six weeks away from school or desk work, and avoid heavy lifting and contact sports for about six to eight weeks while the breastbone heals. The surgeon gives sternum precautions in writing. Antibiotic cover before dental work may be recommended for a period. Ask for the operation report, imaging and discharge summary for your home cardiologist, and see how our process works for coordinated follow-up.
What results can I expect after VSD closure?
Most children with a successfully closed isolated VSD have a normal or near-normal life expectancy and activity level. The echocardiogram shortly after surgery shows whether any small residual leak remains; tiny leaks often do not matter and may close. Growth catches up over months, and symptoms such as sweating and fast breathing usually disappear within weeks. Follow-up with a cardiologist continues at intervals because of the small chance of rhythm problems or valve changes later.
What are the risks of interventricular septal defect surgery?
All open-heart surgery carries risk, which depends on age, weight, the type of defect and any other heart conditions. Possible complications include bleeding, infection, a residual hole, temporary or permanent heart block needing a pacemaker, other rhythm disturbances, valve leakage, fluid around the lungs or heart and, rarely, stroke or death. For simple isolated VSDs in specialist centres, the outcome is good, but you should ask for the centre's own results. The British Heart Foundation and the NHS describe heart-rhythm problems and a small leftover shunt as the main concerns. A catheter device adds a risk of device movement or damage to nearby valves.
How do I choose a congenital heart centre, and what are the red flags?
Look for a hospital with a dedicated paediatric or congenital cardiac surgery team, a paediatric intensive care unit, specialist anaesthetists and perfusionists, and on-site echocardiography. Ask how many VSD closures the team performs each year. Red flags include a quote with no review of scans, a promise of no risk, one operation recommended for every case and pressure to pay a deposit. Send the echocardiogram report and images through our free quote page for a written plan.
Questions to ask the clinic:
- What type and size is the defect, and does it need closing now?
- Is patch surgery or device closure suitable, and why?
- How many such repairs does the team perform each year, and what are its results?
- How long will we stay in intensive care, on the ward and in Turkey?
- What follow-up scans and local cardiologist letters will you provide?
Conditions treated with Interventricular Septal Defect Surgery
Hospitals with Cardiac Surgery in Turkey
Frequently asked questions
It is an operation to close a hole in the wall between the heart's two lower chambers (a VSD). The surgeon usually sews a patch over the hole during open-heart surgery, while some defects can be closed with a device through a catheter.
No. Small defects often shrink or close by themselves and are simply monitored. Closure is advised when the hole is large, causes heart failure symptoms, raises lung pressure or damages a nearby valve.
Approximate ranges are €9,000 to €25,000 in Turkey, against about €20,000 to €45,000 in the UK. The price varies with the type of defect, the age of the patient, intensive care time and any extra procedures, and is confirmed in a written quote.
The operation takes about three to five hours. Intensive care usually lasts one to two days, followed by a ward stay of around five to eight days if there are no complications.
Babies recover quickly. Older children and adults usually need two to six weeks off school or work and avoid heavy lifting and contact sports for six to eight weeks while the breastbone heals.
Neither is right in every case. Device closure avoids the heart-lung machine but suits only selected muscular and some perimembranous defects. Patch surgery is used for most others.
Yes, if the hole is still significant and lung pressure is not too high. In long-standing severe pulmonary hypertension the hole usually cannot be closed safely, so a congenital cardiologist must assess each case.
Risks include bleeding, infection, a small leftover hole, heart rhythm problems that can need a pacemaker, valve leakage and, rarely, stroke. Isolated VSD repair in a specialist centre has a good outcome.
Most children with a successfully closed, isolated VSD have normal activity and growth. Regular cardiology follow-up continues to check for any small residual leak or rhythm change.
Allow about two to three weeks for open-heart repair so the child can be checked after intensive care and have a follow-up echocardiogram before flying. Catheter closure often needs a shorter stay.
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