NATURAL PRGRESSION AND OPERATIVE RESULTS OF SUBARTERIAL VENTRICULAR SEPTAL DEFECT WITH AORTIC VALVULAR DEFORMITY

Li Hong1, Leung Ping2, Lun Kinshing3, et al

1Guangdong Cardiovascular Institute, Guangzhou, China

2Grantham Hospital, Hong Kong, China

3Queen Elizabeth Hospital, Hong Kong, China

 

Objective: To evaluate the natural history of the development and progression of aortic valve prolapse and aortic regurgitation (AR) in Subarterial ventricular septal defect (VSD).

Methods: Between June 1975 and October 1999, 214 patients (137 male, 77 female) with subarterial VSD were studied. Their ages ranged from 4.0 months to 39.7 years (mean, 12.5 ± 0.5 years). All available data, including clinical, echocardiographic, angiographic and surgical information were reviewed in detail.

Results: The follow-up period extended from 1.5 months to 24.3 years (mean, 8.6 ± 0.4 years). Seventy-five patients (35%) with congestive heart failure had early closure of VSD. None developed aortic valve prolapse or AR. Among the other 139 patients, 102 patients (73%) developed aortic valve prolapse. At 1-, 5-, 10- and 15 years old, 8%, 30%, 64% and 83% patients developed respectively. Seventy-eight percent of patients developed AR after prolapsing of aortic valve. Fifty percent of patients had increasing AR on follow-up. Forty-eight patients (22%) were operated for significant AR or aortic valve prolapse. AR was improved in 95% of patients. Only 2 patients (5%) required subsequent aortic valve replacement for increasing AR.

Conclusions: Aortic valve prolapse and AR are progressive in most patients. Surgical intervention is recommended if there is any progression of aortic valve prolapse.

 
1328