Open Surgical Repair of Ventricular Septal Defect with Cardiopulmonary Bypass

Surgical repair may be considered when the defect is large or the anatomy is not suitable for transcatheter closure, when there are concomitant malformations requiring simultaneous treatment (such as outflow tract problems, valve lesions), when there is a risk of aortic valve prolapse/regurgitation, or when previous intervention has been unsuccessful. The decision is based on a comprehensive assessment of defect type and location, pulmonary vascular resistance, comorbidities, age, weight, overall health, and anesthesia risk, as determined by the cardiac surgery team.