Surgery for aortic insufficiency associated with ventricular septal defect.
Aortic valve repair in children is a challenge. We have adopted a technique of single aortic cusp extension with an autologous pericardial strip in patients diagnosed with severe aortic insufficiency (AI) associated with a ventricular septal defect (VSD). The purpose of this study was to report the short-term outcomes. Seven patients were operated on between January 2002 and December 2003. The mean age was 11.28 +/- 2.1 years (range 8-14 years). The VSD was closed with a synthetic patch. Aortic cusp extension was performed at the right coronary cusp in 6 patients and the remainder had a non-coronary cusp extension. The mean diastolic arterial pressure increased from 35.71 +/- 6.09 to 74.28 +/- 7.31 mm Hg after the operation ( p < 0.001). The postoperative grade of AI was trivial in 4 patients, mild in 1 patient and non-existent in 2 patients. The mean follow-up period was 12.85 +/- 6.12 months (range 2-20 months). This technique is very effective in patients with severe AI associated with a VSD. However, long-term durability will need to be carefully followed.
Rergkliang
Chareonkiat
C
Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Prince of Songkla University, Songkhla 90110, Thailand. chareonkiat@yahoo.com
Chittithavorn
Vorawit
V
Chetpaophan
Apirak
A
Vasinanukorn
Prasert
P
D000293:Adolescent; D001022:Aortic Valve Insufficiency / Q000209:etiology* / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000150:complications* / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D010496:Pericardium / Q000637:transplantation*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome