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Yasunaru Kawashima
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Ann Thorac Surg 1980;29:529-533
© 1980 The Society of Thoracic Surgeons

Articles

Tetralogy of Fallot Associated with Aortic Insufficiency

Hikaru Matsuda, M.D.*, Katsuhiko Ihara, M.D., Tohru Mori, M.D., Soichiro Kitamura, M.D., Yasunaru Kawashima, M.D.

First Department of Surgery, Osaka University Medical School, Fukushima-ku, Osaka, Japan

Accepted for publication November 28, 1979.

* Address reprint requests to Dr. Matsuda, Division of Cardiovascular Surgery, Ohtemae Hospital, Ohtemaeno-cho, Higashi-ku, Osaka 540, Japan

Five patients with tetralogy of Fallot associated with aortic insufficiency were studied. They ranged from 6 to 34 years old (mean, 14 years), and 2 patients had a history of subacute bacterial endocarditis. Four patients had a bulboventricular type of ventricular septal defect. Prolapse of the right coronary cusp was the main cause of aortic insufficiency. Deformed valve secondary to subacute bacterial endocarditis and severe dilatation of the aortic annulus were the other causes. In addition to repair of the tetralogy defect, aortic valvuloplasty was performed in 2 patients. In the remaining 3 patients, the ventricular septal defect was closed with a relatively small-sized patch and no aortotomy was made. Four patients survived the operation, and no residual aortic insufficiency was observed in 3 of them. The etiology and the method of operation are discussed.




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