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Ann Thorac Surg 1992;53:851-853
© 1992 The Society of Thoracic Surgeons

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Articles

Infundibular septal defect with severe aortic regurgitation: A new surgical approach

^a Department of Cardiac Surgery, Ospedali Riuniti, Bergamo, Italy
^b Centro Cardiovascolare E. Malan, University of Milan, San Donato Milanese Milan, Italy
^c Centre Cardio-thoracique de Monaco, Monaco Italy

Accepted for publication October 22, 1991.

^_* Address reprint requests to Dr Bonhoeffer, Department of Cardiac Surgery, Ospedali Riuniti, 24100 Bergamo, Italy.

Aortic regurgitation associated with prolapse of an aortic cusp and an infundibular septal defect is caused by the lack of anatomical support for the aortic annulus by the conal septum. This fact is taken into consideration in the new surgical approach that we performed in 5 children 3 to 16 years of age with infundibular ventricular septal defect and severe aortic regurgitation. The ventricular septal defect is closed by a patch anchored to another patch through the prolapsed cusp. This second patch is pulled up with the prolapsed cusp and is then fixed in the aortic wall. In all 5 patients, all clinical signs of aortic insufficiency disappeared, and only minimal aortic regurgitation could be demonstrated by color Doppler mapping.

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