Key result
Postoperative VSD leakage is linked to an eighteenfold increase in late aortic regurgitation progression.
Why the study?
Postoperative progression of aortic regurgitation sometimes occurs after subpulmonic infundibular VSD repair despite early operation before AR development, but its occurrence rate and predictors are unclear.
What are the occurrence rate and predictors of late aortic regurgitation progression in patients after subpulmonic infundibular VSD repair alone?
Cohort (n=91)
What are the occurrence rate and predictors of late aortic regurgitation progression in patients after subpulmonic infundibular VSD repair alone?
Late aortic regurgitation progression occurs in nearly 8% of patients after subpulmonic infundibular VSD repair alone, strongly associated with postoperative VSD leakage.
Residual VSD leak may predict late AR progression (7.7%) after isolated subpulmonic repair; leaves open optimal surveillance or intervention thresholds.
OBJECTIVE: In patients with subpulmonic infundibular ventricular septal defect (VSD), postoperative progression of aortic regurgitation (AR) sometimes occurs despite early operation before the development of AR. The present study was aimed to identify the occurrence rate and predictors of late AR progression after VSD repair alone. METHODS: We retrospectively investigated 91 consecutive patients who underwent subpulmonic infundibular VSD repair alone and were followed up with echocardiography for >3 years postoperatively. The clinical backgrounds and chronological changes in postoperative AR were evaluated. RESULTS: The median follow-up period after VSD repair was 13.4 years. Among 91 patients, 7 patients showed postoperative AR progression (AR progression group) and 84 patients did not (No AR progression group). No patient in AR progression group revealed more than moderate AR preoperatively. The incidence of postoperative VSD leakage was significantly higher in AR progression group than No AR progression group (43.0% vs 2.4%, respectively; p<0.01). No significant differences were present in sex, age, preoperative AR severity, VSD diameter or rate of cusp herniation. All patients in AR progression group showed deformity of the right coronary cusp or leaflet, resulting in AR progression. CONCLUSIONS: Among patients with subpulmonic infundibular VSD, the incidence of late AR progression after VSD repair alone was unexpectedly high (7.7%). Postoperative VSD leakage may be a significant risk factor for late AR progression. Long-term follow-up of postoperative AR is needed even for patients who undergo VSD repair alone.
No takes yet. Share an insight, caveat, or question.
Amano et al. (2016) conducted a cohort in Subpulmonic infundibular ventricular septal defect (VSD) (n=91). Postoperative AR progression vs. No postoperative AR progression was evaluated on Postoperative VSD leakage (p=<0.01). Postoperative VSD leakage was significantly more frequent in patients who developed late aortic regurgitation progression compared to those who did not (43.0% vs 2.4%; p<0.01).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: