In situ patch closure of ventricular septal defect with aortic regurgitation

Aortic valve prolapse (AVP) in patients with a ventricular septal defect (VSD) is known to be caused by high gradient flow through the defect. In adult patients, VSD may lead to AVP and subsequent aortic regurgitation (AR). Although aortic valvuloplasty and the concurrent closure of the defect is the therapy of choice for children, it carries a high risk of reoperation in adults. We present a case of a 20-year-old male with perimembranous outlet type VSD and severe AR. During the operation, the non-coronary cusp was inverted towards the defect and used as an in situ patch. The severely deformed coronary cusps were excised and the aortic valve was replaced.