Aortic regurgitation (AR) due to a prolapsed aortic cusp(prolapsing AR) is one of the most common complications seen in Japanese patients with ventricular septal defect (VSD) [1, 2]. This fact is clearly demonstrated in that well-trained pediatric cardiologists in Japan usually expect to find this condition in almost every child presenting with VSD, especially if the patient has a less than moderate defect. Many clinicians who deal with the condition now consider that prolapsing aortic valve associated with VSD might be specific to Japanese or Oriental people.
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