Correction of adult-type VSD causing aortic valve endocarditis through aortotomy.

João Pedro Monteiro, Diogo Rijo, Sara Simões Costa, Rodolfo Pereira, Manuela Vieira, Paulo Ponce, Luís Vouga, Paulo Neves
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Abstract

Ventricular septal defects are the most common congenital abnormality diagnosed in children but account for only 10 percent of congenital heart defects in adults. Although many defects close spontaneously before adulthood, many others persist, predisposing to endocarditis, and other complications. Herein, we report a case of a known, asymptomatic, perimembranous ventricular septal defects that has complicated at 53 years of age with the need for surgery due to native aortic valve endocarditis and concomitant severe aortic regurgitation. We opted to surgically repair the ventricular septal defects with a pericardial patch through the necessary aortotomy used for aortic valve replacement (Figure 1 and 2). The surgery was straightforward. Postoperative course was only marked by the need of a permanent pacemaker implantation due to a sick sinus syndrome, which was diagnosed before the surgery. Thus, we emphasize the role of surgery in repairing ventricular septal defects and the importance of choosing the appropriate approach, especially when concomitant heart lesions are present.

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主动脉切开术矫正成人型室间隔缺损致主动脉瓣心内膜炎。
室间隔缺陷是儿童中最常见的先天性异常,但仅占成人先天性心脏缺陷的10%。虽然许多缺陷在成年前自然消失,但许多缺陷仍然存在,易导致心内膜炎和其他并发症。在此,我们报告一例已知的无症状的膜周围室间隔缺陷,在53岁时因先天性主动脉瓣心内膜炎和伴随严重的主动脉反流而合并手术。我们选择手术修复室间隔缺损,心包补片通过必要的主动脉切开术用于主动脉瓣置换术(图1和2)。手术很简单。术后过程中唯一的标志是需要永久性起搏器植入由于病窦综合征,这是在手术前诊断。因此,我们强调手术在修复室间隔缺损中的作用,以及选择合适的入路的重要性,特别是当伴有心脏病变时。
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