Right Coronary Cusp Prolapse Resembling Subpulmonic Stenosis in an Old Adult Patient with Ventricular Septal Defect
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Ventricular septal defect (VSD) can be associated with various complications such as aortic regurgitation (AR). AR in VSD come from a deficiency or hypoplasia of the conal septum which leads to abnormal apposition in diastole and prolapse of the poorly supported noncoronary or right coronary cusp through the VSD into the right ventricle resembling subpulmonic stenosis and subsequently results in distortion of the aortic valve and progressive AR. AR often increases in severity with age and it indicates a worse prognosis. Therefore, appropriate timing of surgical repair in progressive AR in VSD might be important. Until now,many earlier experiences about surgical repair of AR complicating VSD were on adolescents or young adults. We reported a case of AR in 48-year-old male patient with right coronary cusp prolapse complicating the subarterial type of VSD which was properly assessed by echocardiography and was successfully treated with surgical repair. Right coronary cusp or noncoronary cusp prolapse should be suspected in AR complicating VSD through proper echocardiographic assessment and the surgical repair on VSD and distorted aortic valve should be considered in the old patient, as well as the young.
Abstract
Ventricular septal defect (VSD) can be associated with various complications such as aortic regurgitation (AR). AR in VSD come from a deficiency or hypoplasia of the conal septum which leads to abnormal apposition in diastole and prolapse of the poorly supported noncoronary or right coronary cusp through the VSD into the right ventricle resembling subpulmonic stenosis and subsequently results in distortion of the aortic valve and progressive AR. AR often increases in severity with age and it indicates a worse prognosis. Therefore, appropriate timing of surgical repair in progressive AR in VSD might be important. Until now,many earlier experiences about surgical repair of AR complicating VSD were on adolescents or young adults. We reported a case of AR in 48-year-old male patient with right coronary cusp prolapse complicating the subarterial type of VSD which was properly assessed by echocardiography and was successfully treated with surgical repair. Right coronary cusp or noncoronary cusp prolapse should be suspected in AR complicating VSD through proper echocardiographic assessment and the surgical repair on VSD and distorted aortic valve should be considered in the old patient, as well as the young.
참고문헌 (23)
- Ammash NM, "Ventricular septal defects in adults", Ann Intern Med, 135, pp.812~824 (2001)
- Soto B, "Classification of ventricular septal defects", Br Heart J, 43, pp.332~343 (1980)
- Ueda M, "The infundibular septum in normal hearts and in hearts with isolated ventricular septal defect. A comparison between Japanese and Dutch hearts", Jpn Heart J, 27, pp.635~643 (1986)
- Elgamal MA, "Risk factors for failure of aortic valvuloplasty in aortic insufficiency with ventricular septal defect", Ann Thorac Surg, 68, pp.1350~1355 (1999)
- Kidd L, "Second natural history study of congenital heart defects. Results of treatment of patients with ventricular septal defects", Circulation, 87, pp.38~51 (1993)
- Neumayer U, "Small ventricular septal defects in adults", Eur Heart J, 19, pp.1573~1582 (1998)
- Gabriel HM, "Long-term outcome of patients with ventricular septal defect considered not to require surgical closure during childhood", J Am Coll Cardiol, 39, pp.1066~1071 (2002)
- Lue HC, "Ventricular septal defect in Chinese with aortic valve prolapse and aortic regurgitation", Heart Vessels, 2, pp.111~116 (1986)
- Mori K, "Echocardiographic evaluation of the development of aortic valve prolapse in supracristal ventricular septal defect", Eur J Pediatr, 154, pp.176~181 (1995)
- 손대원, "심초음파를 이용한 호흡곤란의 평가", Journal of Cardiovascular Ultrasound, 12(1), pp.5~9 (2004), 한국심초음파학회
- Pieroni DR, "Second natural history study of congenital heart defects. Ventricular septal defect: echocardiography", Circulation, 87, pp.80~88 (1993)
- Garg A, "Doppler assessment of interventricular pressure gradient across isolated ventricular septal defect", Clin Cardiol, 13, pp.717~721 (1990)
- Schmidt KG, "Doubly committed subarterial ventricular septal defects: echocardiographic features and surgical implications", J Am Coll Cardiol, 12, pp.1538~1546 (1988)
- Backer CL, "Surgical management of the conal (supracristal) ventricular septal defect", J Thorac Cardiovasc Surg, 102, pp.288~295 (1991)
- Momma K, "Natural history of subarterial infundibular ventricular septal defect", Am Heart J, 108, pp.1312~1317 (1984)
- Mahoney LT, "Acyanotic congenital heart disease. Atrial and ventricular septal defects, atrioventricular canal, patent ductus arteriosus, pulmonic stenosis", Cardiol Clin, 11, pp.603~616 (1993)
- Menahem S, "Evaluation of aortic valve prolapse in ventricular septal defect", Br Heart J, 56, pp.242~249 (1986)
- Leung MP, "Long-term follow-up after aortic valvuloplasty and defect closure in ventricular septal defect with aortic regurgitation", Am J Cardiol, 60, pp.890~894 (1987)
- Otterstad JE, "Long term results after operative treatment of isolated ventricular septal defect in adolescents and adults", Acta Med Scand, 708, pp.1~39 (1986)
- Ellis JH 4th, "Ventricular septal defect in the adult: natural and unnatural history", Am Heart J, 114, pp.115~120 (1987)
- Gersony WM, "Second natural history study of congenital heart defects. Quality of life of patients with aortic stenosis, pulmonary stenosis, or ventricular septal defect", Circulation, 87, pp.52~65 (1993)
- Warnes CA, "American College of Cardiology; American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease); American Society of Echocardiography; Heart Rhythm Society; International Society for Adult Congenital Heart Disease; Society for Cardiovascular Angiography and Interventions; Society of Thoracic Surgeons. ACC", AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology, J Am Coll Cardiol, pp.2008, 52[DOI]
- Mongeon FP, "Indications and outcomes of surgical closure of ventricular septal defect in adults", JACC Cardiovasc Interv, 3, pp.290~297 (2010)