Summary
Fourteen consecutive cases of ventricular septal defect (VSD) associated with aortic
insufficiency (AI) are considered from a pathological and surgical point of view.
In one operated patient the AI was due to previous endocarditis with perforation of
both coronary cusps. In the remaining 6 cases one or 2 aortic cusps were prolapsed.
Closure of VSD was accomplished with teflon patches in 6 and with direct suture in
one. The aortic valve was replaced with an aortic Bjork-Shiley prosthesis in one case,
and simple valve reconstruction was carried out in the remaining 6 patients. There
was no mortality.
In 3 patients who presented with residual AI one month after operation, the cardiothoracic
ratio and the electrocardiogram have nevertheless returned progressively to normal
limits.
The authors favor correction at preschool age on the principle that early closure
of the VSD may prevent or control the AI. However, in small children in whom the severity
of AI may suggest the necessity for valve replacement, the operation is postponed
as long as possible to avoid functional prosthetic stenosis later in life.
Key words
Interventricular septal defect - Aortic insufficiency - Electrocardiogram - Phonocardiogram
