Key result
In situ patch closure of a ventricular septal defect using the inverted non-coronary cusp during concomitant aortic valve replacement resulted in no residual shunt at 6-month follow-up.
Case Report (n=1)
No
Using the non-coronary cusp as an in situ patch for VSD closure during concomitant aortic valve replacement is a feasible technique in select adult patients with severe aortic regurgitation and VSD.
May support feasibility in select adults; hypothesis-generating and requires prospective validation.
Aortic valve prolapse (AVP) in patients with a ventricular septal defect (VSD) is known to be caused by high gradient flow through the defect. In adult patients, VSD may lead to AVP and subsequent aortic regurgitation (AR). Although aortic valvuloplasty and the concurrent closure of the defect is the therapy of choice for children, it carries a high risk of reoperation in adults. We present a case of a 20-year-old male with perimembranous outlet type VSD and severe AR. During the operation, the non-coronary cusp was inverted towards the defect and used as an in situ patch. The severely deformed coronary cusps were excised and the aortic valve was replaced.
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Büyükbayrak et al. (2013) conducted a case report in Ventricular septal defect with severe aortic regurgitation (n=1). In situ patch closure of VSD using non-coronary cusp and aortic valve replacement was evaluated on Residual shunt at 6 months. In situ patch closure of a ventricular septal defect using the inverted non-coronary cusp during concomitant aortic valve replacement resulted in no residual shunt at 6-month follow-up.
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