Surgical Treatment and Long-Term Follow-up in Ventricular Septal Defect Associated with Aortic Regurgitation

Between 1973 and January 1990, 14 patients, ages ranging between 4-18 years (mean: 9.3±3.8) underwent open heart surgery with the diagnosis of ventricular septal defect and aortic insufficiency. The ventricular septal dected was subpulmonic in 8 and intracristal in 6 patients. The aortic regurgitation was minimal in 8. moderate in 4 and severe in 2 cases. The surgical procedure was closure of ventricular septal decet alone in 9 patients, while in 3 patients aortic valvuloplasty was added. In 2 patients, ventricular septal defect closure was combined with aortic valve replacement. One of the latter patients was lost on the eighth postoperative day because of arrhythmia. Two patients subjected to valvuloplasty were reoperated; one 4 months postoperatively because of increasing aortic regurgitation and the other 8 years later due to recurrent ventricular septal defect and aortic regurgitation. During a mean follow-up of 10.4 years, 8 patients remained free of aortic regurgitation while there has been no increase in the minimal aortic insufficiency in the other 4 patients. One patient in whom aortic valve has been replaced is living in good condition 6 years postoperatively.