Repair of a Supracristal Ventricular Septal Defect in an Adult

Ventricular septal defects (VSDs) are the most common congenital cardiac abnormalities occurring in five out of every 1000 births. Supracristal VSDs (located above the crista supraventicularis) are very rare and comprise only 2%-3% of all VSDs. Many VSDs close spontaneously during childhood; however, a substantial portion may not and are present in adulthood with a myriad of symptoms. We describe the management of a complex case of an adult patient with a supracristal VSD and resultant severe aortic insufficiency (AI) in the perioperative setting.