We reviewed the Doppler echocardiographic findings of the aortic valve and
associated aortic regurgitation (AR) in 55 patients who underwent patch clo
sure of doubly committed subarterial ventricular septal defect (VSD). The m
aximal diameter of the VSD measured greater than or equal to 5 mm, whereas
the postoperative follow-up interval was greater than or equal to 5 years.
Twenty-three patients underwent closure before they developed aortic cusp p
rolapse or AR (group A). In 15 patients the VSD was closed when aortic cusp
prolapse was recognized, but AR was absent (group B), Aortic cusp prolapse
with AR was detected before closore in a further 15 patients (group C). Of
8 patients with no AR before closure, AR was detected during follow-up in
6 group A and in 2 group B patients. In group C, AR resolved after surgery
in 4 patients, whereas AR grade improved in a further 8 patients and remain
ed unchanged in 3. Although residual AR was more frequent in patients with
aortic cusp prolapse and AR before closure, it was silent and asymptomatic.
(C) 2000 by Excerpta Medica, Inc.