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[II-JCKO6-04] The fate of aortic valve after doubly commiitted juxtaarterial ventricular septal defect repair
Background
In patients with doubly commiitted juxtaarterial ventricular septal defect (DCJA VSD), postoperative fate of the aortic valve remains unclear. Postoperative progression of aortic regurgitation (AR) sometimes occur despite early operation before the development of AR. This review is to identify the incidence and predictors of late AR progression after VSD repair. And to find out the optimal timing for VSD repair with or without right coronary cusp (RCC) prolapse or AR.
Methods
From Jan 2002 to Dec 2013, the medical records of 90 consecutive patients who underwent DCJA VSD repair alone at our hospital were reviewed. Preoperative evaluation showed 43 patients (48%) had RCC prolapse and 22 (24%) had AR. Among 22 patients, 4 had mild AR and no patients had more than moderate. Operative approach was through the pulmonary artery in all patients.
Results
Operative survival was 100%. The median follow up period after VSD repair was 3.5 years. Among 90 patients, 4 patients showed postoperative progressive AR. Of the 90 patients with long-term echo follow up, 1 had mild AR, 2 had moderate AR. AR was improved in 18 patients.
Conclusion
Among patients with DCJA VSD, the incidence of AR progression after VSD repair was much lower than expected in our study. Early operation may be the keys to prevent progressive AR. In the present study, most patients underwent VSD repair at the age of < 24months when had no more than faint AR. Regrettably, having few patients with late AR progression after VSD repair, it was unable to analysis the risk factors of postoperative AR progression.
In patients with doubly commiitted juxtaarterial ventricular septal defect (DCJA VSD), postoperative fate of the aortic valve remains unclear. Postoperative progression of aortic regurgitation (AR) sometimes occur despite early operation before the development of AR. This review is to identify the incidence and predictors of late AR progression after VSD repair. And to find out the optimal timing for VSD repair with or without right coronary cusp (RCC) prolapse or AR.
Methods
From Jan 2002 to Dec 2013, the medical records of 90 consecutive patients who underwent DCJA VSD repair alone at our hospital were reviewed. Preoperative evaluation showed 43 patients (48%) had RCC prolapse and 22 (24%) had AR. Among 22 patients, 4 had mild AR and no patients had more than moderate. Operative approach was through the pulmonary artery in all patients.
Results
Operative survival was 100%. The median follow up period after VSD repair was 3.5 years. Among 90 patients, 4 patients showed postoperative progressive AR. Of the 90 patients with long-term echo follow up, 1 had mild AR, 2 had moderate AR. AR was improved in 18 patients.
Conclusion
Among patients with DCJA VSD, the incidence of AR progression after VSD repair was much lower than expected in our study. Early operation may be the keys to prevent progressive AR. In the present study, most patients underwent VSD repair at the age of < 24months when had no more than faint AR. Regrettably, having few patients with late AR progression after VSD repair, it was unable to analysis the risk factors of postoperative AR progression.