Korean J Thorac Cardiovasc Surg.  2004 Jun;37(6):492-498.

Aoric Valve Lesion in Type I Ventricular Septal Defect

• Lee JR
• Kim KC
• Lim HG
• Kim WH
• Kim YJ
• Rho JR
• Bae EJ
• Noh CI
• Yun YS
• Ahn C

Abstract

BACKGROUND: In this study, we investigated the risk factors for the development or progression of aortic regurgitation(AR) in patients with type I ventricular septal defect (VSD) to determine the optimal surgical timing and strategy. MATERIAL AND METHOD: Three-hundred and ten patients with type I VSD with or without AR were included. The mean of age was 73.7+/-114.7 (1~37) months. One hundred and eighty six patients (60%) had no AR, 83 (27%) had mild AR, 25 (8%) had moderate AR and 16 (5%) had severe AR. Aortic valve was repaired in 5 patients and replaced in 11 patients with closure of VSD in the first operation. Four patients required redo aortic valve repair and 11 patients required redo aortic valve replacement. Age at operation, association with aortic valve prolapse, Qp/Qs, systolic pulmonary arterial pressure, VSD size and systolic pulmonary artery to aortic pressure ratio(s[PAP/AP]) were included as risk factors analysis for the development of AR. The long-term result of aortic valve repair and aortic valve replacement were compared. RESULT: Older age at operation, association with aortic valve prolapse, high Qp/Qs, and s[PAP/AP] were identified as risk factors for the development of AR (p<0.05, Table 2). The older the patient at the time of operation, the higher the severity of preoperative AR and the incidence of postoperative AR (p<0.05, Table 1, Fig. 1). For the older patients at operation, aortic valve repair had higher occurrence of AR compared to those who had aortic valve replacement (p<0.05, Fig. 2).
CONCLUSION
From the result of this study, we can concluded that early primary repair is recommended to decrease the progression of AR. Aortic valve repair is not always a satisfactory option to correct the aortic valve pathology, which may suggest that aortic valve replacement should be considered when indicated.

Keyword

Heart septal defect, ventricular; Heart septal defects; Aortic valve insufficiency

MeSH Terms

Aortic Valve
Aortic Valve Insufficiency
Aortic Valve Prolapse
Arterial Pressure
Heart Septal Defects
Heart Septal Defects, Ventricular*
Humans
Incidence
Pathology
Pulmonary Artery
Risk Factors