Syndrome of Ventricular Septal Defect and Aortic Regurgitation - A 22-Year Review of its Management

Abstract Introduction: The presence of aortic regurgitation (AR) in the setting of ventricular septal defect (VSD) has always been a management challenge. Methods: This is a retrospective study looking at patients who underwent VSD closure with or without aortic valve intervention between January...

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Main Authors: Sivakumar Krishnasamy, Sivakumar Sivalingam, Jeswant Dillon, Raja Amin Raja Mokhtar, A. Yakub, Ramesh Singh
Format: Article
Language:English
Published: Sociedade Brasileira de Cirurgia Cardiovascular 2021-04-01
Series:Brazilian Journal of Cardiovascular Surgery
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382021000600807&tlng=en
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author Sivakumar Krishnasamy
Sivakumar Sivalingam
Jeswant Dillon
Raja Amin Raja Mokhtar
A. Yakub
Ramesh Singh
author_facet Sivakumar Krishnasamy
Sivakumar Sivalingam
Jeswant Dillon
Raja Amin Raja Mokhtar
A. Yakub
Ramesh Singh
author_sort Sivakumar Krishnasamy
collection DOAJ
description Abstract Introduction: The presence of aortic regurgitation (AR) in the setting of ventricular septal defect (VSD) has always been a management challenge. Methods: This is a retrospective study looking at patients who underwent VSD closure with or without aortic valve intervention between January 1st, 1992 and December 31st, 2014 at the Institute Jantung Negara. This study looked at all cases of VSD and AR, where AR was classified as mild, moderate, and severe, the intervention done in each of this grade, and the durability of that intervention. The interventions were classified as no intervention (NI), aortic valve repair (AVr), and aortic valve replacement (AVR). Results: A total of 261 patients were recruited into this study. Based on the various grades of AR, 105 patients had intervention to their aortic valve during VSD closure. The rest 156 had NI. All patients were followed up for a mean time of 13.9±3.5 years. Overall freedom from reoperation at 15 years was 82.6% for AVr. Various factors were investigated to decide on intervening on the aortic valve during VSD closure. Among those that were statistically significant were the grade of AR, size of VSD, age at intervention, and number of cusp prolapse. Conclusion: We can conclude from our study that all moderate and severe AR with small VSD in older patients with more than one cusp prolapse will need intervention to their aortic valve during the closure of VSD.
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spelling doaj.art-45ccf49b40134fa78651080ebd6c8bd02022-12-22T03:28:19ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-97412021-04-0136680781610.21470/1678-9741-2020-0207Syndrome of Ventricular Septal Defect and Aortic Regurgitation - A 22-Year Review of its ManagementSivakumar KrishnasamySivakumar Sivalingamhttps://orcid.org/0000-0002-2996-1775Jeswant DillonRaja Amin Raja MokhtarA. YakubRamesh SinghAbstract Introduction: The presence of aortic regurgitation (AR) in the setting of ventricular septal defect (VSD) has always been a management challenge. Methods: This is a retrospective study looking at patients who underwent VSD closure with or without aortic valve intervention between January 1st, 1992 and December 31st, 2014 at the Institute Jantung Negara. This study looked at all cases of VSD and AR, where AR was classified as mild, moderate, and severe, the intervention done in each of this grade, and the durability of that intervention. The interventions were classified as no intervention (NI), aortic valve repair (AVr), and aortic valve replacement (AVR). Results: A total of 261 patients were recruited into this study. Based on the various grades of AR, 105 patients had intervention to their aortic valve during VSD closure. The rest 156 had NI. All patients were followed up for a mean time of 13.9±3.5 years. Overall freedom from reoperation at 15 years was 82.6% for AVr. Various factors were investigated to decide on intervening on the aortic valve during VSD closure. Among those that were statistically significant were the grade of AR, size of VSD, age at intervention, and number of cusp prolapse. Conclusion: We can conclude from our study that all moderate and severe AR with small VSD in older patients with more than one cusp prolapse will need intervention to their aortic valve during the closure of VSD.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382021000600807&tlng=enAortic Valve InsufficiencyReoperationHeart Septal Defects, VentricularHeart Valve ProsthesisCardiac Surgical ProceduresProlapse
spellingShingle Sivakumar Krishnasamy
Sivakumar Sivalingam
Jeswant Dillon
Raja Amin Raja Mokhtar
A. Yakub
Ramesh Singh
Syndrome of Ventricular Septal Defect and Aortic Regurgitation - A 22-Year Review of its Management
Brazilian Journal of Cardiovascular Surgery
Aortic Valve Insufficiency
Reoperation
Heart Septal Defects, Ventricular
Heart Valve Prosthesis
Cardiac Surgical Procedures
Prolapse
title Syndrome of Ventricular Septal Defect and Aortic Regurgitation - A 22-Year Review of its Management
title_full Syndrome of Ventricular Septal Defect and Aortic Regurgitation - A 22-Year Review of its Management
title_fullStr Syndrome of Ventricular Septal Defect and Aortic Regurgitation - A 22-Year Review of its Management
title_full_unstemmed Syndrome of Ventricular Septal Defect and Aortic Regurgitation - A 22-Year Review of its Management
title_short Syndrome of Ventricular Septal Defect and Aortic Regurgitation - A 22-Year Review of its Management
title_sort syndrome of ventricular septal defect and aortic regurgitation a 22 year review of its management
topic Aortic Valve Insufficiency
Reoperation
Heart Septal Defects, Ventricular
Heart Valve Prosthesis
Cardiac Surgical Procedures
Prolapse
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382021000600807&tlng=en
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