title: Evolution of aortic regurgitation following simple patch closure of doubly committed subarterial ventricular septal defect.
abstract: We reviewed the Doppler echocardiographic findings of the aortic valve and associated aortic regurgitation (AR) in 55 patients who underwent patch closure of doubly committed subarterial ventricular septal defect (VSD). The maximal diameter of the VSD measured > or = 5 mm, whereas the postoperative follow-up interval was > or = 5 years. Twenty-three patients underwent closure before they developed aortic cusp prolapse or AR (group A). In 15 patients the VSD was closed when aortic cusp prolapse was recognized, but AR was absent (group B). Aortic cusp prolapse with AR was detected before closure in a further 15 patients (group C). Of 8 patients with no AR before closure, AR was detected during follow-up in 6 group A and in 2 group B patients. In group C, AR resolved after surgery in 4 patients, whereas AR grade improved in a further 8 patients and remained unchanged in 3. Although residual AR was more frequent in patients with aortic cusp prolapse and AR before closure, it was silent and asymptomatic.
authors.affiliation: Department of Pediatrics and Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Tomita
authors.forename: Y
authors.initials: Y
authors.lastname: Arakaki
authors.forename: Y
authors.initials: Y
authors.lastname: Ono
authors.forename: O
authors.initials: O
authors.lastname: Yamada
authors.forename: S
authors.initials: S
authors.lastname: Tsukano
authors.forename: T
authors.initials: T
authors.lastname: Yagihara
authors.forename: S
authors.initials: S
authors.lastname: Echigo
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001022:Aortic Valve Insufficiency / Q000145:classification / Q000000981:diagnostic imaging / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007223:Infant; D012189:Retrospective Studies; D012720:Severity of Illness Index