Echocardiographic evaluation of the development of aortic valve prolapse in supracristal ventricular septal defect

The development and timing of aortic weve prolapse (AoVP) and aortic regugitation (AR) was studied by two limensional echocardiography in 99 consecutive patients with supracristal ventricular septal defect (VSD). Thirty patients (30%) had aortic valve prolapse (VSD+AoVP group), and 31 patients (31%) had AoVP with AR (VSD+AoVP+AR group). In the VSD+AoVP group, AoVP was detected first by echocardiography at the age of 6.8±4.2 years (mea±SD). In the VSD+AoVP+AR group, the interval from detection of AoVP to the appearance of Al was 3.4±2.0 years. The configuration of the prolapsed aortic valve was echocardiographically classified into two types: teardrop type (small) prolapse and box type (large) prolapse. The frequency of tear-drop tyrolapse was not significantly different between VSD+AoVP and VSD+AoVP-AR groups (43% versus 32%, respectively), indicating that even minor AoVP can result, AR. Four infants (4%) had AoVP at the ages of 1, 5, 7, and 11 months, respectively. All infants had tear-drop type prolapse. Two infants developed AR by colour flow mapping at the ages of 3 and 11 months, and the interval from prolapse to AR was only 2 and 4 months, respectively.Conclusion Aortic valce, involement can develop under the age of 1 year in supracristal VSD. Regular evaluation by two-dimensional echocardiography with colour flow mapping is important in the followup of children with supracristal VSD.