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Surgery for Aortic Insufficiency Associated with Ventricular Septal Defect

Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Prince of Songkla University, Songkhla, Thailand

For reprint information contact: Chareonkiat Rergkliang, MD Tel: 66 74 451 401 Fax: 66 74 429 384 Email: chareonkiat{at}yahoo.com, Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Prince of Songkla University, Songkhla 90110, Thailand.

Aortic valve repair in children is a challenge. We have adopted a technique of single aortic cusp extension with an autologous pericardial strip in patients diagnosed with severe aortic insufficiency (AI) associated with a ventricular septal defect (VSD). The purpose of this study was to report the short-term outcomes. Seven patients were operated on between January 2002 and December 2003. The mean age was 11.28 ± 2.1 years (range 8–14 years). The VSD was closed with a synthetic patch. Aortic cusp extension was performed at the right coronary cusp in 6 patients and the remainder had a non-coronary cusp extension. The mean diastolic arterial pressure increased from 35.71 ± 6.09 to 74.28 ± 7.31 mm Hg after the operation ( p < 0.001). The postoperative grade of AI was trivial in 4 patients, mild in 1 patient and non-existent in 2 patients. The mean follow-up period was 12.85 ± 6.12 months (range 2–20 months). This technique is very effective in patients with severe AI associated with a VSD. However, long-term durability will need to be carefully followed.