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Three Decades of Follow-up After Surgical Closure of Subarterial Ventricular Septal Defect

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Abstract

We determined the occurrence of aortic regurgitation (AR), AR progression and risk factors in patients followed up for up to three decades after closure of subarterial VSD. We reviewed the outcomes of 86 patients categorized into three groups: group I comprised 37 patients without AR and had VSD closure alone, group II comprised 40 patients with AR and had VSD closure without aortic valvoplasty, and group III comprised 9 patients with AR and required both VSD closure and aortic valvoplasty. Patients were followed up for 18.9 ± 7.3 years (median 19.5 years, range 3.5–36.6). At latest follow up, 54.7% (47/86) of patients had AR. The prevalence of progression of AR from any one grade to the next one higher was 37.2% (32/86). Freedom from AR progression was 75.6%, 52.1%, and 22.2% at 20 years of follow-up for groups I, II and III, respectively (p < 0.05). On the other hand, progression to moderate to severe AR occurred only in 4.7% (4/86). Group I and II patients were free from progression to significant AR, while only 33.3% of group III patients were free from progression on follow-up (p < 0.001). Multivariate Cox regression analysis showed that severity of preoperative AR was the significant risk factor for persistence and progression of postoperative AR after VSD closure. In conclusion, aortic regurgitation is common and may progress even after surgical repair of subarterial VSD. Severity of preoperative AR is the most significant predictor of persistence and progression of AR after surgical closure of subarterial VSD.

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Data Availability

Data generated by our study that supports the conclusion of our article are available from the corresponding author upon reasonable request for research use.

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Funding

This study did not receive any grant support.

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Authors and Affiliations

  1. Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, 102, Pokfulam Road, Hong Kong, China

    Vanessa Amaral, Edwina Kam-fung So, Pak-cheong Chow & Yiu-fai Cheung

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  1. Vanessa Amaral
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  2. Edwina Kam-fung So
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  3. Pak-cheong Chow
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  4. Yiu-fai Cheung
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Contributions

VA Conceptualization, Methodology, Investigation, Writing-original draft preparation. KS Formal analysis, Data curation. PC Resources, Writing-review & editing. YC Supervision, Conceptualization, Writing-review & editing.

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Correspondence to Yiu-fai Cheung.

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Conflict of interest

All of the authors declare no conflict of interest.

Ethical Approval

The review of clinical records, without additional procedures performed in patients and the need to obtain informed consent, was approved by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster, Hong Kong, China, and in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Not applicable as this is a retrospective chart review.

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Not applicable as this is a retrospective chart review.

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Amaral, V., So, E.Kf., Chow, Pc. et al. Three Decades of Follow-up After Surgical Closure of Subarterial Ventricular Septal Defect. Pediatr Cardiol 42, 1216–1223 (2021). https://doi.org/10.1007/s00246-021-02603-3

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  • DOI: https://doi.org/10.1007/s00246-021-02603-3

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