Department of Cardiovascular Surgery, Kartal Koşuyolu Heart and Research Hospital, İstanbul

Background: We present the long-term results of patients operated for aortic regurgitation accompanying ventricular septal defect (VSD). Methods: Out of 314 patients operated for VSD between 1985-2004, 9 patients (2.86%) (7 males, 2 females; mean age 21.44±12.9 years; range 8 to 45 years) had VSD associated with aortic regurgitation. In six patients VSD was subaortic whereas in three patients it was located in the perimembranous septum. Two patients had history of infective endocarditis. VSD was repaired via transaortic route in four cases. In three of the remaining five patients, the defect was reached and repaired through right atrial incision, in one patient through right ventricular incision and in one patient through both right atrial and right ventricular incisions. In eight patients VSD was repaired with dacron patch and in one patient with native inverted insitu right coronary cusp tissue. In three cases with moderate aortic regurgitation, resuspension was performed to relieve regurgitation. Aortic valve replacement was performed in six patients with aortic valves unsuitable for repair. Results: Mean follow-up of patients was 62.5±40 (7-120) months. There was no early mortality. Atrioventricular block was not observed in any of patients. Significant aortic regurgitation was not detected upon postoperative echocardiographic controls of three patients who underwent aortic valve repair. Postoperative mean functional capacity showed significant improvement in accordance to preoperative values (p=0.016). On echocardiographic measurements, a statistically significant improvement was detected between preoperative and postoperative mean left ventricular endsystolic and end-diastolic diameters (p=0.034, <0.0001). Conclusion: Long-term results of patients operated for ventricular septal defect associated with aortic regurgitation are good and left ventricular functions and funtional capacity show significant improvement after both aortic valve repair and replacement.