Aortic Regurgitation After Surgical Repair of Outlet-Type Ventricular Septal Defect
Aortic Regurgitation After Surgical Repair of Outlet-Type Ventricular Septal Defect
The major risk factors of aortic valve replacement in three outlet types VSD after surgical
 repair were the severity of preoperative AR and older operation age. For those patients with
 less than moderate degree AR preoperatively, AR progressed rarely and all in those with
 aortic valvar and subvalvar anomalies.
Progression of aortic regurgitation (AR) in repaired outlet (juxta-arterial, muscular outlet
 and perimembranous outlet) ventricular septal defect (VSD) remains unclear.

 From 1987 to 2002, 411 patients with complete follow-up after repair of outlet VSD
 constituted the study population. Study end point was aortic valve replacement or mortality.

 Aortic valve replacement was performed in seventeen patients (4.1%), in whom logistic
 regression showed only the severity of preoperative AR and age at VSD repair as the
 predictors. After excluding the eleven patients with endocarditis from analysis, there were
 377 patients with none to mild AR (Group I) and 23 with moderate to severe AR (Group II)
 preoperatively. Total follow-up was 2,230 person-years. After VSD repair, the 5- and 10-year
 freedom from aortic valve replacement in Group I was 100%, and in Group II 50.2%. In Group
 II, ten patients received aortic valve replacement and 8 underwent valvuloplasty with VSD
 repair. One patient needed valve replacement four years later. Age at VSD repair was the
 predictor for aortic valve replacement. In Group I, AR progressed in four patients (1.2%, two
 juxta-arterial and two perimembranous outlet) 3.5 to 7.9 years later and was associated with
 aortic valvar or subvalvar anomalies. The event-free curves in three outlet types VSD showed
 no differences.

 Although AR progressed rarely (probably not in muscular outlet type) in repaired outlet types
 VSD with none to mild preoperative AR, in the presence of aortic valvar or subvalvar
 anomalies, early surgical repair of the VSD is still warranted.
Inclusion Criteria:

 -  ventricular septal defect patients receiving total repair from Jan, 1987 to Dec, 2002.

 -  follow up more than 1 year after operation

 Exclusion Criteria:

 -  complex cardiac lesions