Abstract
A case of 30 years’ male, a farmer by occupation who was a diagnosed case of a ventricular septal defect (VSD) since the age of seven, but refused for surgical closure back then, came in the emergency room (ER) with decompensated congestive cardiac failure and peripheral edema. After initial stabilization, he underwent transthoracic echocardiography (TTE) that showed small perimembranous VSD with the left to right shunt, a subaortic membrane with severe left ventricular outflow tract (LVOT) obstruction and moderate aortic and mitral regurgitation. TTE was followed by Computed Tomography (CT) thoracic aortogram that revealed small VSD with significant aortic regurgitation (AR). Subaortic membrane, aneurysmal dilated aortic root and ascending aorta and aneurysmal dilated pulmonary arteries. Cardiac surgeons were taken onboard and advised for VSD closure with aortic valve replacement, subaortic membrane resection and aortic root replacement. Patient and family were counseled regarding the procedure but refused again for surgical closure. Key Words: Ventricular Septal Defect, Aortic Regurgitation, Subaortic Membrane, Pulmonary Roots Dilation, Adult
Highlights
Pulmonary artery dilatation, aortic root dilatation, and aortic regurgitation (AR) all have been reported as complications of perimembranous ventricular septal defect (VSD)
The association of VSD and AR was first described by Laubry and Pezzi in 1921.7 AR results due to prolapse of the aortic leaflets and is most commonly reported with supra cristal VSD and is an associated lesion in approximately three to eight percent of the patients with overall VSD and with perimembranous type, it is rarely seen.[2]
Aortic dilation is most commonly reported with tetralogy of fallot (TOF), transposition of the great arteries (TGA) and truncus arteriosus and few reports are related to VSD.[4]
Summary
VENTRICULAR SEPTAL DEFECT WITH SEVERE AORTIC REGURGITATION, SUB AORTIC STENOSIS, AORTIC AND PULMONARY ROOTS DILATION IN AN ADULT: A CASE REPORT. All authors declared no conflict of interest. This article may be cited as: Nadeem D, Mueed A, Akhtar P. Ventricular Septal Defect with Severe Aortic Regurgitation, Sub Aortic stenosis, Aortic and Pulmonary Roots Dilation in an Adult: a case report.
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