Ventricular Septal Defect and Aortic Insufficiency

Six cases of aortic insufficiency were found among 203 patients with ventricular septal defect cathe-terized during a 10-year period. The clinical, haemo-dynamic and angiographic findings are presented and compared with data previously reported in the literature. It is often possible to make a presumptive clinical diagnosis on the basis of auscultatory findings, symptoms of aortic insufficiency, increased pulmonary markings on chest X-rays and electrocardiographic and roentgeno-logic evidence of left ventricular strain. For a final diagnosis and elucidation of the anatomical details both right-sided heart catheterization and aortography are necessary.The clinical picture is variable, with a tendency to poor prognosis in those patients with marked aortic insufficiency.Using extracorporal circulation, closure of the ventricular septal defect and plastic repair of the aortic cusp were performed in 5 patients. One patient died postoperatively, improvement was seen in 3 and no change in condition was noticed in the remaining patient.