VENTRICULAR SEPTAL DEFECT WITH SEVERE AORTIC REGURGITATION, SUB AORTIC STENOSIS, AORTIC AND PULMONARY ROOTS DILATION IN AN ADULT: A CASE REPORT

Abstract

A case of 30 years’ male, a farmer by occupation who was a diagnosed case of a ventricular septal defect (VSD) since the age of seven, but refused for surgical closure back then, came in the emergency room (ER) with decompensated congestive cardiac failure and peripheral edema. After initial stabilization, he underwent transthoracic echocardiography (TTE) that showed small perimembranous VSD with the left to right shunt, a subaortic membrane with severe left ventricular outflow tract (LVOT) obstruction and moderate aortic and mitral regurgitation. TTE was followed by Computed Tomography (CT) thoracic aortogram that revealed small VSD with significant aortic regurgitation (AR). Subaortic membrane, aneurysmal dilated aortic root and ascending aorta and aneurysmal dilated pulmonary arteries. Cardiac surgeons were taken onboard and advised for VSD closure with aortic valve replacement, subaortic membrane resection and aortic root replacement. Patient and family were counseled regarding the procedure but refused again for surgical closure.