Further insights into the syndrome of prolapsing non-coronary aortic cusp and ventricular septal defect

Abstract

Ventricular septal defect (VSD) with prolapse of the right coronary cusp and aortic regurgitation can be managed surgically with the anatomical correction technique. However when the VSD is located underneath the non coronary cusp surgical management differs due to anatomical constraints and secondary pathological changes seen in the non coronary cusp. It is therefore important that the location of the VSD and the morphology of prolapsing cusp be characterised preoperatively in order to plan appropriate surgical repair. We present a case study in which we discuss the salient differences in the surgical management of the prolapsing right and the prolapsing non coronary cusps.

Laubry-Pezzi Syndrome in an Adult Male Patient and Its Surgical Correction: A Case Report and Literature Review

“…Such a defect causes prolapse of the aortic right coronary cusp due to both scarcity of leaflet support and Venturi's phenomenon [2]. The pathophysiology of the Venturi's effect in the case of VSD is described as when blood traverses through the defect and if it is situated beneath the aortic valve where the fall of pressure aspirates the right coronary or noncoronary cusp resulting in AI or AR [4]. AI complicates the course of patients' subcristal VSDs five times as often as patients with perimembranous VSDs [5].…”

Long-term complications after surgical correction of Laubry-Pezzi syndrome

“…Laubry-Pezzi syndrome is defined as the association of ventricular septal defect (VSD) and aortic regurgitation (AR) due to a prolapsing right coronary or less frequently non-coronary cusp (1). The pathophysiology is explained by Venturi's effect: when blood passes through the VSD located underneath the aortic valve, the fall of pressure aspirates the right coronary or non-coronary cusp resulting in AR (2).…”