Single cusp replacement in patients with ventricular septal defect and aortic insufficiency

J Card Surg. 2015 Jun;30(6):520-4. doi: 10.1111/jocs.12543. Epub 2015 Apr 14.

Abstract

Objective: The aim of this study was to analyze the mid- and long-term outcome of single cusp replacement in patients with ventricular septal defect and aortic insufficiency.

Methods: From September 2005 through March 2014, 172 patients underwent single cusp replacement and ventricular septal defect (VSD) closure. The median age was 19.5 years (range, 9 months to 67 years). Additional techniques were used to repair associated anomalies including sinus of Valsalva aneurysm, patent ductus arteriosus, patent foramen ovale, subaortic membrane, and intramural coronary artery.

Results: One patient with large left ventricle (preoperative end-diastolic diameter: 9.8 cm) died after the procedure from incurable heart failure. Four patients required a second pump run for residual aortic insufficiency (AI) (two patients, 1.16%) and residual VSD (two patients, 1.16%). Four patients required re-exploration for postoperative bleeding or cardiac tamponade. Mean follow-up was 53.27 ± 25.37 months (median, 56.5 months; range, 3 to 104 months). Redo aortic valve surgery was performed in three patients. Three patients had moderate-severe AI during the following period without reoperation. There was no post-operative endocarditis.

Conclusion: Single cusp replacement can be safely used in patients with VSD-AI.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aortic Valve Insufficiency / complications
  • Aortic Valve Insufficiency / surgery*
  • Cardiac Surgical Procedures / methods*
  • Cardiovascular Abnormalities / complications
  • Cardiovascular Abnormalities / surgery
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Heart Septal Defects, Ventricular / complications
  • Heart Septal Defects, Ventricular / surgery*
  • Heart Valve Prosthesis Implantation / methods*
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Reoperation
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome
  • Young Adult