Abstract
Background
Perimembranous and sub arterial Ventricular Septal Defects (VSD) are associated with Aortic Regurgitation (AR) in 5 % of patients. More than mild AR needs additional valve intervention during VSD closure. Feasibility of aortic valve repair and its superior results over aortic valve replacement have been documented well. The purpose of this study is to present our initial experience in aortic valve repair in young children with aortic regurgitation.
Materials and methods
Fourteen out of thirty-one consecutive VSD closures had AR (45.16 %) and six of them (19.35 %) needed intervention. The median age and weight were 8.1 years and 18.7 Kg. The VSD was perimembranous in 5 and sub arterial in 1. The predominant pathology was leaflet prolapse in 5 (right coronary cusp-3, Non coronary cusp-1 and both coronary cusps-1)
Results
Five had successful aortic valve repair and one underwent aortic valve replacement after a failed valve repair. The technique of repair consisted of commissural placation with cusp shortening, resuspension and bicuspidisation. There were no deaths. Follow-up was 100 % complete at a median of 6 months. AR was trivial in 2, and mild in 3. All are in NYHA class I. Patient with mechanical valve had major anticoagulation-related intra-cerebral bleed needing neurosurgical intervention.
Conclusion
Early intervention for VSD would possibly prevent aortic valve disease. Aortic valve repair is the procedure of choice in young patients with VSD-AR syndrome and can be performed with low risk, and the freedom from valve-related morbidity and mortality is excellent. Valve repair also avoids anticoagulation related complications.
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Muthialu, N., Balakrishnan, S., Sundar, R. et al. Aortic valve repair in young patients with ventricular septal defect with aortic regurgitation- our experience. Indian J Thorac Cardiovasc Surg 29, 1–4 (2013). https://doi.org/10.1007/s12055-013-0180-x
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DOI: https://doi.org/10.1007/s12055-013-0180-x