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.