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The outcome of ventricular septal defect combined with aortic regurgitation after surgical repair

摘要Objective:Ventricle septal defect(VSD)is commonly associated with aortic regurgitation and aortic leaflet prolapse due to anatomic and hemodynamic factors.The concomitant intervention of the aortic valve during VSD repair remains one of the major concerns.Moreover,little is known about the structure and hemodynam-ic change in the presence of postoperative progressive AR after VSD repair.Methods:From August 2012 to Febru-ary 2019,VSD patients with aortic regurgitation who underwent VSD surgical repair with or without aortic valve in-tervention in our institution were retrospectively reviewed.Preoperative echo and postoperative echo in the follow-up were collected and compared.Results:The mean age of the patients on VSD repair was 3.2.Those with postoper-ative progressive aortic regurgitation showed significantly increased right atrium,mean pulmonary artery,valve flow velocity,and A-wave velocity,and significantly reduced right ventricle outflow tract and descending aorta flow velocity(P<0.05).Additionally,compared with no AR intervention,aortic valvuloplasty during VSD repair predis-pose patients to have progressive AR(P<0.05).Conclusion:There was augmented capacity in the right-heart sys-tem and increased valvular flow velocity in the left-heart system in VSD patients combined with postoperative AR.Additional aortic valvuloplasty or aortic valve replacement during surgical VSD repair might not be necessary,espe-cially for those with no or mild AR preoperatively.Aortic valve replacement,if required,is a more appropriate alterna-tive in halting postoperative AR progression than aortic valvuloplasty.[S Chin J Cardiol 2022;23(2):162-168]

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岭南心血管病杂志(英文版)

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