Factors associated with aortic root dilatation after surgically repaired ventricular septal defect

Area of Science:

• Cardiology
• Congenital Heart Disease
• Aortic Diseases

Background:

• Aortic root dilatation (ARD) is a serious complication in congenital heart disease, increasing risks of aortic aneurysm, rupture, and dissection.
• Understanding factors contributing to ARD in surgically repaired ventricular septal defect (VSD) patients is crucial for long-term management.

Purpose of the Study:

• To identify specific factors associated with aortic root dilatation (ARD) in patients who have undergone surgical repair for ventricular septal defect (VSD).

Main Methods:

• A cross-sectional study involving 152 patients with surgically repaired VSD.
• Two definitions for ARD were applied: Valsalva diameter to body surface area (BSA) ratio >2.1 cm/m² and absolute Valsalva diameter ≥4.0 cm.
• Multivariate logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for ARD presence.

Main Results:

• The prevalence of ARD varied between 8.6% and 32.9% based on the definition used.
• Nonsubarterial VSD type (OR 5.65) and preoperative right- or noncoronary cusp prolapse (R/NCCP) (OR 3.68) were significantly associated with ARD.
• These associations remained significant after adjusting for sex, age at repair, VSD size, and follow-up duration.

Conclusions:

• Anatomical features, including nonsubarterial VSD type and preoperative R/NCCP, are independent predictors of ARD in surgically repaired VSD patients.
• The findings hold true regardless of the specific ARD definition employed.
• Patients with surgically repaired VSD require vigilant monitoring for potential ARD development.