Outflow Ventricular Septal Defect with Aortic Regurgitation: Optimal timing of Surgery?

Author(s):  
Priya Giridhara ◽  
Amitabh Poonia ◽  
Deepa S. Kumar ◽  
Kavassery M. Krishnamoorthy ◽  
Sivasankaran Sivasubramonian ◽  
...  
2019 ◽  
Vol 40 (8) ◽  
pp. 1696-1702
Author(s):  
Hanna Jung ◽  
Joon Yong Cho ◽  
Youngok Lee

Abstract In patients with subarterial ventricular septal defect (VSD), the progression of aortic regurgitation (AR) still remains unclear. This review is to identify the incidence of AR progression after VSD repair and to determine the optimal operation timing for subarterial VSD repair with or without aortic valve prolapse or AR. From January 2002 to December 2015, 103 patients who underwent subarterial VSD repair alone at our hospital were reviewed. All patients routinely underwent echocardiography (echo) performed by our pediatric cardiologists. The operative approach was through the pulmonary artery in all patients. The median age of patients at operation was 10 months (range 3 to 16.5 months). Eighty-nine patients (86.4%) underwent subarterial VSD closure before the age of 4 years. In the preoperative evaluation, 27.2% (28 patients) of the patients showed more than faint degree AR. The mean follow-up duration after VSD repair was 6.6 ± 4.0 years. In the latest follow-up echo after VSD repair, four patients had more than mild degree AR owing to aortic valve abnormalities or delayed operation period. Among them, AR progression occurred in only one patient (0.98%). Early and accurate assessment of the anatomical morphology of the aortic valve and optimal operation timing may be important to achieve better outcomes after repair and to prevent the development of aortic valve complications.


1987 ◽  
Vol 43 (4) ◽  
pp. 363-367 ◽  
Author(s):  
Kouichi Hisatomi ◽  
Kenichi Kosuga ◽  
Tadashi Isomura ◽  
Haruo Akagawa ◽  
Kiroku Ohishi ◽  
...  

2013 ◽  
Vol 1 ◽  
pp. 31-33
Author(s):  
Fuat Buyukbayrak ◽  
Eray Aksoy ◽  
Serpil Gezer Tas ◽  
Mehmet Dedemoglu ◽  
Mete Alp

1986 ◽  
Vol 41 (5) ◽  
pp. 489-491 ◽  
Author(s):  
Yutaka Ohkita ◽  
Shigehito Miki ◽  
Kenji Kusuhara ◽  
Yuichi Ueda ◽  
Takafumi Tahata ◽  
...  

2017 ◽  
Vol 10 (4) ◽  
pp. 240
Author(s):  
Redoy Ranjan ◽  
Asit Baran Adhikary ◽  
Mohammad Rashal Chowdhury ◽  
Md. Kabiruzzaman ◽  
Md. Mushfiqur Rahman

<p>A 4 year old girl was presented with the respiratory tract infection, breathlessness after taking meal, failure to thrive, abnormal movement of the chest on left side overlying the area of heart and systolic murmur. She developed these symptoms gradually for the last 3.5 years. Echocardiography revealed doubly committed subarterial ventricular septal defect with moderate aortic regurgitation. The size of the ventricular septal defect was 7 x 9 mm at the left ventricular outflow tract. The right coronary cusp of the aortic valve was prolapsed. Left atrium and left ventricle were dilated. The pulmonary artery systolic pressure was 35 mm Hg. The ventricular septal defect was closed with the standard surgical procedure using cardiopulmonary bypass followed by aortotomy and right atriotomy. Immediate post-operative period of this case was uneventful and the patient was discharged on 9<sup>th</sup> post-operative day. Follow-up echocardiography showed no residual ventricular septal defect or aortic regurgitation and the ventricular function was good.</p>


2020 ◽  
Vol 30 (5) ◽  
pp. 599-606
Author(s):  
Zhaoyang Chen ◽  
Wanhua Chen ◽  
Hang Chen ◽  
Zhenmei Liao ◽  
Qiang Chen ◽  
...  

AbstractBackground:Outcome data of doubly committed subarterial ventricular septal defect closure in adults are limited.Methods:A review was made of the inpatients >18 years of age who underwent doubly committed subarterial ventricular septal defect closure between June 2010 and June 2017.Results:The patients were categorised into two groups: The valve intervention group consisted of 31 patients who underwent aortic valvuloplasty, aortic valve replacement, or repair of sinus Valsalva aneurysm in addition to doubly committed subarterial ventricular septal defect closure; non-valvular intervention group comprised 58 patients who underwent only doubly committed subarterial ventricular septal defect closure. The groups did not differ by sex and age. Patients in the valve intervention group, with a larger ventricular septal defect size, were shorter and tended to be lighter. The valve intervention group had more patients with pneumonia perioperatively. No infective endocarditis and reoperation were noted during the study period. At last follow-up, 91 and 96.6% of the studied patients were free from left ventricle dilation and pulmonary hypertension. In patients without pre-operative aortic regurgitation, 12 developed new mild aortic regurgitation during the follow-up.Conclusions:About 34.8% of adult patients with doubly committed subarterial ventricular septal defect required concurrent intervention on aortic valve or sinus Valsalva aneurysm. The midterm results of doubly committed subarterial ventricular septal defect closure in adult patients were favourable. However, the incidence of new mild aortic regurgitation after ventricular septal defect closure was high (27.3%). Long-term follow-up of aortic regurgitation progression is needed.


1988 ◽  
Vol 96 (5) ◽  
pp. 769-774 ◽  
Author(s):  
Yutaka Okita ◽  
Shigehito Miki ◽  
Kenji Kusuhara ◽  
Yuichi Ueda ◽  
Takafumi Tahata ◽  
...  

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