Prof. Dr. Ali Serdar Fak
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- 29+years exp.
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Congenital Heart Disease
Ventricular septal defect surgery
What a ventricular septal defect is, which holes close on their own and which need surgery, how patch repair and transcatheter device closure work, approximate costs in Turkey against the UK, US and Germany, recovery for children and adults, the risks including heart block, and how to check a congenital heart team.
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Dr. Bülent İlçöl
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Ventricular septal defect surgery in Turkey: what is a VSD and when is it closed?
A ventricular septal defect (VSD) is a hole in the wall (septum) between the two lower chambers of the heart. Because pressure in the left ventricle is higher than in the right, blood leaks through the hole from left to right and flows again through the lungs, which makes the heart and the lungs work harder. It is one of the most common congenital heart conditions and is usually found in babies from a murmur, poor feeding or breathlessness. Adults can also have a VSD, either one that was never closed or, rarely, a hole that forms after a heart attack. Ventricular septal defect surgery closes the hole, most often with a patch, so that blood can no longer pass between the chambers.
Not every VSD needs an operation. This guide explains how the decision is made, how closure works, what it costs in Turkey compared with the UK, US and Germany, what recovery is like and what the risks are. For related defects see our pages on atrial septal defect surgery and congenital heart disease.
Does my child's VSD need surgery, or can it be left alone?
Size, position and symptoms decide. Small holes often cause no symptoms and many close by themselves in early childhood; the NHS and the British Heart Foundation describe regular checks as the usual plan for a small VSD. A moderate or large hole may cause fast breathing, sweating during feeds, poor weight gain and repeated chest infections, and these babies are usually operated on in the first months or the first year to prevent high pressure damaging the lung blood vessels. Closure is also advised when there is heart enlargement, when the hole sits near the aortic valve and the valve begins to leak, or when infection of the heart lining has occurred.
The heart team bases the decision on an echocardiogram (heart ultrasound), an ECG and sometimes a cardiac catheter study or MRI. If a hole is large and left untreated for years, the lung pressure can rise permanently (Eisenmenger syndrome), at which point closure may no longer be safe. That is why timing matters, and why a congenital cardiology opinion should come before any trip is planned. Our page on interventricular septal defect surgery covers the same condition under its other name.
Which types of VSD are there, and why does the type matter?
- Perimembranous: in the upper part of the septum, the most common type; usually closed with a surgical patch.
- Muscular: in the muscular lower wall, sometimes multiple; some can be closed with a catheter device.
- Outlet (supracristal): just below the pulmonary and aortic valves; may allow the aortic valve to prolapse and leak, see replacement of the aortic valve if the valve is damaged.
- Inlet: near the tricuspid and mitral valves; often part of a wider atrioventricular canal defect.
The type decides the route to the hole and which methods are possible, and it affects the risk of damaging the heart's electrical pathway that runs close to the perimembranous area.
How is a VSD closed? Surgery, device closure or watchful waiting
The table sets out the three realistic options. A paediatric cardiologist and a congenital heart surgeon decide together.
| Option | Best suited to | Typical limits |
|---|---|---|
| Open-heart patch closure | Moderate or large VSDs, perimembranous, outlet and inlet types, infants with symptoms | Needs a heart-lung machine and a chest incision; a hospital stay and scar |
| Transcatheter device closure | Selected muscular or some perimembranous defects in suitable-sized patients | Not possible for every shape or position; risk of heart block or device leak |
| Monitoring only | Small VSDs without symptoms or heart enlargement | Needs regular scans; endocarditis precautions advised by the cardiologist |
Related operations are described on our congenital heart surgery page.
What happens during VSD patch closure, step by step?
The operation is done under general anaesthesia and normally takes three to five hours. The surgeon opens the chest through a median sternotomy (some centres use a smaller lower incision), and the blood is routed through a heart-lung machine while the heart is stopped with a cooling solution. The hole is reached through the right atrium, so the ventricle usually does not need to be cut. It is closed with a patch of the child's own pericardium or a synthetic material, sewn in with stitches placed away from the conduction pathway. The heart is restarted, the machine is weaned off, and temporary wires and drains are left in place. A heart ultrasound in the operating room confirms that the repair is sound.
Children go to intensive care for one or two days. The ventilator is often removed within hours, and the drains and wires are removed over the next days.
Ventricular septal defect surgery cost in Turkey compared with the UK, US and Germany
The figures are approximate ranges for the operation and a standard hospital stay, and are not hospital quotes. Children's congenital surgery is priced by case complexity, the intensive-care stay and the team involved.
| Country | Approximate cost range |
|---|---|
| Turkey | €8,000 – €25,000 |
| United Kingdom (private) | €20,000 – €45,000 |
| United States | €40,000 – €120,000 |
| Germany | €18,000 – €40,000 |
A package normally includes the consultation, tests and echocardiogram, the operation, the anaesthetist and perfusion team, intensive-care days, ward stay, medication and transfers. Ask whether a parent's accommodation, a second echocardiogram before discharge, and complications requiring a longer stay or a pacemaker are included, since these can change the final bill.
How long is the recovery after VSD surgery?
- Intensive care: one to two days, often with breathing support for a few hours.
- Hospital: usually five to seven days, longer if rhythm problems or fluid build-up need monitoring.
- Weeks 1 to 2 at home: rest, gentle walking, wound checks, simple painkillers.
- Weeks 4 to 6: the breastbone heals; older children avoid contact play and lifting; many return to nursery or school after about four to six weeks.
- Three months: an echocardiogram and a clinic check confirm the repair.
Families should plan to stay about ten to fourteen days in Turkey so the team can check the chest, rhythm and the echo before the flight home. Adults generally return to desk work after about six to eight weeks and to full activity after about three months. Cardiac follow-up should be organised with a congenital cardiologist at home before you leave.
What results can be expected after VSD closure?
After successful closure most children grow and feed better within weeks, breathe more easily and have no restriction on normal activity once the chest has healed. The scar down the chest fades over months. Many people live a normal life after repair, but the heart still needs checks: some have a small residual leak, rhythm changes or need advice on dental hygiene and endocarditis. Long-term review is more intensive if the defect was large, if the lung pressures were raised or if the aortic valve was involved. Echocardiograms are done at intervals set by the cardiologist.
What are the risks of ventricular septal defect surgery?
Open-heart surgery in infants and children is highly specialised, and outcomes for isolated VSD closure are generally good in experienced centres, yet no operation is risk-free. Possible complications include bleeding, infection, a residual hole or leak, rhythm disturbance, complete heart block that needs a pacemaker (the stitches lie close to the conduction pathway), fluid around the heart or lungs, kidney or lung problems after bypass, stroke and, rarely, death. Device closure adds risks of device movement, valve interference and vascular injury at the groin. The British Heart Foundation and the Children's Heart Federation advise families to ask each centre about its own results for VSD closure and to share all previous reports.
How do I choose a congenital heart team, and what should I ask?
The key is the team, not the building: a paediatric cardiac surgeon who performs congenital operations regularly, a paediatric cardiologist, a paediatric intensive-care unit, a paediatric anaesthetist and perfusionists for small hearts. Red flags include a quote given without your child's echocardiogram, promises of a risk-free operation, no clear answer on caseload and no plan for follow-up at home. Read how our process works and see our cardiology treatments in Turkey overview. Questions to ask:
- How many VSD closures does the team perform each year, and what is the complication rate?
- Is patch closure or device closure recommended for this defect, and why?
- What is the risk of heart block, and what happens if a pacemaker is needed?
- Is there a paediatric intensive-care unit on site?
- Who will review my child's echocardiogram and reports at home after the flight?
Send your echocardiogram report and clinic letters through our free quote page, and the hospital will reply with a written assessment and price.
Conditions treated with Ventricular Septal Defect Surgery
Hospitals with Cardiac Surgery in Turkey
Frequently asked questions
A VSD is a hole in the wall between the heart's two lower chambers. Blood leaks from the left to the right side, which strains the heart and lungs if the hole is large.
No. Small holes often cause no problems and many close by themselves in childhood. Surgery is advised for moderate or large holes that cause symptoms, heart enlargement, aortic valve leakage or lung pressure changes.
Approximate ranges are €8,000 to €25,000 in Turkey, against about €20,000 to €45,000 for private care in the UK. The complexity, the intensive-care stay and the team change the price, and the hospital confirms it in writing.
Most are closed in open-heart surgery with a patch sewn over the hole while a heart-lung machine supports the circulation. Some muscular defects can be closed with a catheter device without opening the chest.
Hospital stay is usually five to seven days, with one or two in intensive care. Children often return to school after four to six weeks and adults to desk work after six to eight weeks, once the surgeon agrees.
Outcomes are generally good in experienced congenital heart centres, but there are risks including bleeding, infection, residual leak, rhythm problems and heart block needing a pacemaker. Ask the team about its own results.
Sometimes. Transcatheter device closure suits selected muscular and some perimembranous defects, but not every hole, and it carries its own risks such as heart block or device leak.
Most children grow normally and have no activity limits once healed. Regular heart checks continue, as a small leak, rhythm change or valve problem can occur.
Yes. Adults with a persisting defect that causes symptoms, heart enlargement or valve damage can have closure, provided lung pressures are not permanently raised, which a cardiologist checks first.
Plan about ten to fourteen days so the team can review the chest wound, the rhythm and a follow-up echocardiogram before the flight home. Complications can extend the stay.
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