Aortic Valve Repair Following Ventriculo-septal Defect (VSD) and Severe Aortic Regurgitation: Surgical Techniques, Complications and Follow up Events

Abstract

Background: Aortic regurgitation (AR) is a common sequel resulting from prolapsed of right coronary cusp (RCC), non-coronary cusp (NCC) or both, in the repair of ventricular septal defects (VSD). Objectives: The purpose of presenting these cases is to highlight the fact that aortic valve repair does not only end in addressing the cusp as this will result in moderate aortic regurgitation after surgery. Results: Our first case is a two and half year old male with alarge peri-membranous VSD with RCC prolapse causing co-optation failure and severe AR .The second case is a 12 year old male a large peri-membranous ventriculo-septal defect with RCC prolapsed with severe AR .The third case is a 12 year old female with a large peri-membranous VSD with a significant right coronary cusp prolapsed, severe aortic regurgitation due to non-cooptation of RCC with the remaining cusps with flow reversal in the descending aorta. The last case is a four year, 6-month-old male with a large peri-membranous VSD and severe AR from NCC and RCC prolapse. All had repair of aortic valve with mild regurgitation after several follow up. Conclusion: Aortic valve repair resulting from prolapse of RCC and NCC in children with VSD is expedient as it reduces morbidity and mortality post-operation.