title: Imbalance of cusp width and aortic regurgitation associated with aortic cusp prolapse in ventricular septal defect.
abstract: The Doppler echocardiograms of the aortic valve and associated aortic regurgitation (AR) were reviewed in 72 patients with a ventricular septal defect (VSD). Group I comprised 13 patients without any deformity of the aortic cusp for > or = 10 years, group 2 included 35 patients who did not develop AR for > or = 10 years after right coronary cusp prolapse (RCCP) was first detected, group 3 comprised 11 patients with RCCP and AR in whom the AR remained subclinical for > or = 10 years, and group 4 was 13 patients who underwent surgical treatment because of moderate to severe AR. The cusp imbalance index [width of right (R) or non- (N) coronary cusp/width of left coronary cusp (L)] was compared among the 4 groups. R/L or N/L was larger in group 4 than in groups 1-3; R/L exceeded 1.30 in all the patients in group 4, whereas it was less than 1.30 in all the atients in groups 1-3. Two patients in group 4 with non-coronary cusp prolapse had an N/L greater than 1.50. No other patients in any group had an N/L larger than 1.20. An imbalance of cusp width may predict possible progressive deterioration of AR.
authors.affiliation: Department of Pediatrics, National Cardiovascular Center, Suita, Osaka, Japan. tomitah@hsp.ncvc.go.jp
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: T
authors.initials: T
authors.lastname: Yagihara
authors.forename: S
authors.initials: S
authors.lastname: Echigo
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001021:Aortic Valve / Q000002:abnormalities* / Q000473:pathology / Q000503:physiopathology; D001022:Aortic Valve Insufficiency / Q000209:etiology* / Q000473:pathology; D001023:Aortic Valve Prolapse / Q000150:complications* / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D015150:Echocardiography, Doppler; D006345:Heart Septal Defects, Ventricular / Q000150:complications*; D006801:Humans; D007223:Infant; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors