title: Echocardiographic evaluation of the development of aortic valve prolapse in supracristal ventricular septal defect.
abstract: The development and timing of aortic valve prolapse (AoVP) and aortic regurgitation (AR) was studied by two-dimensional echocardiography in 99 consecutive patients with supracristal ventricular septal defect (VSD). Thirty patients (30%) had aortic valve prolapse (VSD + AoVP group), and 31 patients (31%) had AoVP with AR (VSD + AoVP + AR group). In the VSD + AoVP group, AoVP was detected first by echocardiography at the age of 6.8 +/- 4.2 years (mean +/- SD). In the VSD + AoVP + AR group, the interval from detection of AoVP to the appearance of AR was 3.4 +/- 2.0 years. The configuration of the prolapsed aortic valve was echocardiographically classified into two types: tear-drop type (small) prolapse and box type (large) prolapse. The frequency of tear-drop type prolapse was not significantly different between VSD + AoVP and VSD + AoVP + AR groups (43% versus 32%, respectively), indicating that even minor AoVP can result in AR. Four infants (4%) had AoVP at the ages of 1, 5, 7, and 11 months, respectively. All infants had tear-drop type prolapse. Two infants developed AR by colour flow mapping at the ages of 3 and 11 months, and the interval from prolapse to AR was only 2 and 4 months, respectively.
  
  
  CONCLUSIONS
  Aortic valce involvement can develop under the age of 1 year in supracristal VSD. Regular evaluation by two-dimensional echocardiography with colour flow mapping is important in the follow-up of children with supracristal VSD.
authors.affiliation: Department of Paediatrics, University of Tokushima, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Mori
authors.forename: S
authors.initials: S
authors.lastname: Matsuoka
authors.forename: K
authors.initials: K
authors.lastname: Tatara
authors.forename: Y
authors.initials: Y
authors.lastname: Hayabuchi
authors.forename: M
authors.initials: M
authors.lastname: Nii
authors.forename: Y
authors.initials: Y
authors.lastname: Kuroda
mesh_terms: D017668:Age of Onset; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D001023:Aortic Valve Prolapse / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D015150:Echocardiography, Doppler; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology / Q000601:surgery; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male