Morphological analysis of ventricular septal defect by echocardiography for prediction of aortic regurgitation in pediatric population

Ventricular septal defects (VSD) are the most common congenital heart diseases in children. Among them, perimembranous VSD (pm-VSD) have a higher risk of complications, including aortic valve prolapse and aortic regurgitation (AR). The aim of our study was to assess echocardiographic criteria associated with AR during follow-up of pm-VSD. Forty children with restrictive pm-VSD, followed-up in our unit and who underwent a workable echocardiographic evaluation between 2015 and 2019 were included and retrospectively analyzed. The propensity score was used to match 15 patients with AR to 15 patients without AR. Median age was 2.2 year [1.4-5.7]. Median weight was 14 kg [9.9-20.3]. Aortic annulus z-score, Valsalva sinus z-score, sinotubular junction z-score, valve prolapse and commissure commitment were significantly different between the two groups (p = 0.047, p = 0.001, p = 0.010, p = 0.007, p < 0.001 respectively). Aortic root dilatation, aortic valve prolapse and commissure commitment to a perimembranous VSD are associated to aortic regurgitation.

Automated summary

This study aimed to assess the echocardiographic criteria associated with aortic regurgitation (AR) in children with perimembranous ventricular septal defects (pm-VSD) during follow-up. A retrospective analysis of the echocardiographic evaluation of 40 children with restrictive pm-VSD was performed, and 15 patients with AR were matched to 15 patients without AR using propensity score. The results showed significant differences in aortic annulus z-score, Valsalva sinus z-score, sinotubular junction z-score, valve prolapse, and commissure commitment between the two groups. Aortic root dilatation, aortic valve prolapse, and commissure commitment to a perimembranous VSD are associated with AR.