[A long-term prognosis of ventricular septal defect associated with aortic regurgitation]

Fifty-one cases of ventricular septal defect associated with aortic regurgitation (VSD and AR) were examined for past twenty-two years. Only VSD closure was performed for AR cases under Sellers II regurgitation. After the average of 11.6 years' follow-up, 14 cases retained over 60 mmHg of diastolic pressure and belonged to NYHA functional class 1. VSD closure and aortic cusp suspension were performed for AR cases over Sellers II regurgitation. Three cases operated before 1969 died of cardiac failure and one case recently died of infectious endocarditis (IE). Because of residual AR, one case was performed re-aortic cusp suspension one year after the operation and another case was scheduled for re-aortic cusp suspension after three years and eight months. Eighteen cases with malfunctioned valve caused by calcification, etc. underwent the aortic valve replacement. Early death was due to low cardiac output syndrome (LOS). Five cases were followed up for eleven years on the average. Two cases were found atrial fibrillation and myocardial infarction, respectively. Four cases were VSD + AR with the past history of IE and one died of LOS after surgery. Two cases were postoperative IE. One died three months after the operation and the other is doing well after the re-surgery by translocation. A long-term finding of SV1 + RV5 by electrocardiogram showed a significant decrease in left ventricular overload. Significant decrease of cardiothoracic ratio was observed in AR group under Sellers II regurgitation. Pulse pressure was significantly decreased as well.