Aortic regurgitation (AR) is one of the most important complications occurring in patients with ventricular septal defect (VSD). It occurred in 1.9%–5.5% of all patients with VSD in Western countries [1–6] but occurred at higher rates, 7.0%–13.1%, in Hawaii  and Japan [8, 9], suggesting that a racial difference exists. Aortic valve prolapse might, as proposed by Blumenthal et al.  in 1967, precede the development of AR, particularly in patients with subpulmonic VSD. Whether Chinese, like Japanese, are prone to develop aortic valve prolapse and AR is unknown . Controversies still exist regarding the optimal surgical treatment and timing of the operation for such patients due to a paucity of information [1, 5, 12–16]. To clarify these matters, we started in January, 1978 a prospective study to identify the anatomical type of the VSD and to check the integrity and competency of the aortic valves of all infants and children with VSD to be catheterized at the National Taiwan University Hospital. Another 306 patients with VSD who were catheterized from 1970 to 1977 were also reviewed to determine the type of VSD and the integrity and competency of the aortic valve. An analysis of the results of these two studies forms the basis of this report.
Nadas AS, Thilenius OG, LaFarge CG, Hauck AJ (1964) Ventricular septal defect with aortic regurgitation: Medical and pathologic aspects. Circulation 29: 862–873PubMedCrossRefGoogle Scholar
Nadas AS, Fyler DC (1972) Ventricular septal defect with aortic regurgitation. In: Nadas AS (ed) Pediatric cardiology (3rd edn). Saunders, Philadelphia, p 379Google Scholar
Cooley DA, Garrett HE, Howard HS (1962) The surgical treatment of ventricular septal defect: An analysis of 300 consecutive surgical cases. Prog Cardiovasc Dis 4: 312–323CrossRefGoogle Scholar
Karapawich PP, Duff DF, Mullins CE, Cooley DA et al (1981) Ventricular septal defect with associated aortic valve insufficiency: Progression of insufficiency and operative results in young children. J Thorac Cardiovasc Surg 82: 182–189Google Scholar
Keane JF, Plauth WH, Nadas AS (1977) Ventricular septal defect with aortic regurgitation. Circulation (Supp1) 56: 72–77CrossRefGoogle Scholar
Andersen HK, Lomholt P (1972) Ventricular septal defect and aortic insufficiency. Scand J Thorac Cardiovasc Surg 6: 57–67PubMedCrossRefGoogle Scholar