Monitoring
Asymptomatic individuals should undergo annual clinical follow-up. Issues to be monitored include development of aortic regurgitation, development of tricuspid regurgitation, assessment of left-to-right shunt, ventricular dysfunction, and assessment of pulmonary pressure. Routine surveillance via transthoracic echocardiogram at 3 to 5 yearly intervals is considered appropriate for asymptomatic individuals with small muscular ventricular septal defects (VSDs) or 1 to 2 yearly intervals in asymptomatic children with VSDs in other locations besides muscular septum.[23]
In patients who have undergone repair or closure of a VSD, the degree of residual shunting and development of heart blocks or arrhythmias are additional issues that need to be monitored.
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