Somanath H S, Gupta S K, Reddy K N, Murthy J S, Rao A S, Abraham K A
Railway Institute For Cardiac Research & Treatment, Southern Railway Headquarters Hospital, Madras.
Indian Heart J. 1990 Mar-Apr;42(2):113-6.
The records of 362 patients of Ventricular Septal Defect (VSD) were analysed to find out the incidence of aortic regurgitation (AR) and their hemodynamic and angiographic features. Thirty-seven patients (10.2%) were found to have AR, whose mean age was 13.4 years (range: 2-45) and male to female ratio was 5:1. Of the 37 cases 31 (84%) had infracristal and 6 (16%) had supracristal VSD. In 31 patients with infracristal VSD the prolapsing cusp was Right Coronary Cusp (RCC) in 14 (48%), Noncoronary Cusp (NCC) in 12 (41%) and both RCC and NCC in 3 (11%). Of the 6 patients with supracristal VSD the prolapsing cusp was RCC in 5 (83%) and NCC in 1 (17%). In two patients the AR was due to bicuspid aortic valve. The pulmonary artery pressure was normal in 26 of 37 (70.2%) patients and the left to right shunt was 1.5:1 or less in 23 of 37 (62%) patients. Nineteen of the 37 patients (51.3%) had grade I or II AR and the remaining 18 (48.7%) had grade III or IV AR. There was no relationship between the severity of AR and the location of the VSD. In conclusion, in this series, the incidence of VSD+AR is relatively higher and that of supracristal VSD is lower. In majority of patients the left to right shunt is small and pulmonary artery pressure within normal limits. The prolapse of RCC is more common in supracristal VSD and there is no relation between the severity of AR and the location of the VSD.
分析362例室间隔缺损（VSD）患者的记录，以找出主动脉反流（AR）的发生率及其血流动力学和血管造影特征。发现37例患者（10.2%）有AR，其平均年龄为13.4岁（范围：2-45岁），男女比例为5:1。在这37例病例中，31例（84%）为嵴下型VSD，6例（16%）为嵴上型VSD。在31例嵴下型VSD患者中，脱垂的瓣叶为右冠状动脉瓣叶（RCC）14例（48%），无冠状动脉瓣叶（NCC）12例（41%），RCC和NCC均脱垂3例（11%）。在6例嵴上型VSD患者中，脱垂的瓣叶为RCC 5例（83%），NCC 1例（17%）。2例患者的AR是由于二叶式主动脉瓣所致。37例患者中有26例（70.2%）肺动脉压力正常，37例患者中有23例（62%）左向右分流为1.5:1或更低。37例患者中有19例（51.3%）为I级或II级AR，其余18例（48.7%）为III级或IV级AR。AR的严重程度与VSD的位置之间无相关性。总之，在本系列中，VSD+AR的发生率相对较高，嵴上型VSD的发生率较低。大多数患者左向右分流较小，肺动脉压力在正常范围内。RCC脱垂在嵴上型VSD中更常见，AR的严重程度与VSD的位置之间无相关性。
