A Case of Aortic Regurgitation due to Quadricuspid Aortic Valve with Ventricular Septal Defect and Double Chamber Right Ventricle

Introduction: We present three cases of ruptured sinus of Valsalva aneurysm concomitant with a cardiac lesion in 2 cases of ventricular septal defect and 1 case of bicuspid aortic valve with mild aortic insufficiency. Case presentation: In 2/3 cases, the site of ruptured sinus of Valsalva aneurysm originated from right coronary cusps and one from non-coronary cusps. Both ruptured sinus of Valsalva aneurysm from right coronary cusps communicated to right ventricle, and one that originated from non-coronary cusps ruptured to right atrium. All cases were diagnosed by transthoracic echocardiography and confirmed by transesophageal echocardiography. Two underwent the surgery, while one did not want to continue treatment. Conclusion: ruptured sinus of Valsalva aneurysm is a rare cardiac anomaly. In the Eastern countries, the most common associated anomalies with ruptured sinus of Valsalva aneurysm are ventricular septal defect and aortic regurgitation. Ruptured sinus of Valsalva aneurysm mainly originates from right coronary cusps and is ruptured into right ventricle. Transthoracic echocardiography and transesophageal echocardiography are employed to confirm the diagnosis. In this cohort, the coexistences of ruptured sinus of Valsalva aneurysm with ventricular septal defect and aortic regurgitation (case 1), ventricular septal defect (case 2), aortic regurgitation and bicuspid aortic valve (case 3) are observed.

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Intraoperative diagnosis of a quadricuspid aortic valve

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492317692467 ◽

2017 ◽

Vol 26 (9) ◽

pp. 704-706

Author(s):

Hassan Tatari ◽

Maziar Gholampour Dehaki ◽

Gholamreza Omrani ◽

Hafez Ghaheri ◽

Alwaleed Al-Dairy ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Regurgitation ◽

Septal Defect ◽

Incidental Finding ◽

Aortic Valve Repair ◽

Quadricuspid Aortic Valve ◽

Valve Regurgitation ◽

Valve Repair ◽

Ventricular Septal Defect Closure

Quadricuspid aortic valve is a rare anomaly, and most patients require surgery for aortic regurgitation in the 5th or 6th decades of life; only a few cases of aortic valve repair in childhood have been reported. A 3-year-old boy was scheduled for ventricular septal defect closure and aortic valve repair. Quadricuspid aortic valve was an incidental finding at operation; it was repaired by joining the left anterior and right anterior cusps. At the 9-month follow-up, the patient had no more than mild aortic regurgitation. We emphasize the importance of detecting this anomaly, especially in children with aortic valve regurgitation.

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Outcomes of closure of doubly committed subarterial ventricular septal defects in adults

Cardiology in the Young ◽

10.1017/s1047951120000530 ◽

2020 ◽

Vol 30 (5) ◽

pp. 599-606

Author(s):

Zhaoyang Chen ◽

Wanhua Chen ◽

Hang Chen ◽

Zhenmei Liao ◽

Qiang Chen ◽

...

Keyword(s):

Aortic Valve ◽

Ventricular Septal Defect ◽

Aortic Regurgitation ◽

Septal Defect ◽

Intervention Group ◽

Adult Patients ◽

Defect Closure ◽

Ventricular Septal Defect Closure ◽

Sinus Valsalva Aneurysm

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.

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Progression of Aortic Regurgitation After Subarterial Ventricular Septal Defect Repair: Optimal Timing of the Operation

Pediatric Cardiology ◽

10.1007/s00246-019-02206-z ◽

2019 ◽

Vol 40 (8) ◽

pp. 1696-1702

Author(s):

Hanna Jung ◽

Joon Yong Cho ◽

Youngok Lee

Keyword(s):

Aortic Valve ◽

Ventricular Septal Defect ◽

Aortic Regurgitation ◽

Septal Defect ◽

Preoperative Evaluation ◽

Optimal Operation ◽

Optimal Timing ◽

Mild Degree ◽

Operation Timing

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.

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