Successful Surgical Repair of Semilunar Valves in an Adult Female with Congenital Ventricular Septal Defect

Ventricular septal defect (VSD) is the most common acyanotic congenital heart disease that affects the right heart and pulmonary vascular system by increasing pulmonary vascular resistance. Undiagnosed subaortic VSD may over time cause aortic valve insufficiency as well as severe pulmonary arterial hypertension. Moreover, right heart dilatation can be seen due to the left-to-right shunt through the VSD. The final stages may include irreversible pulmonary artery hypertension (PAH) (Eisenmenger’s syndrome) and right-to-left shunting. In our case report, we present a 45-year-old female patient suffering from exertional dyspnea. She was diagnosed with severe aortic and pulmonary valve insufficiency caused by late-diagnosed VSD. Successful surgical repair of degenerated semilunar valves with concomitant heart defect was performed. Both valves were repaired using autologous pericardium tissue. Instead of performing double mechanical valve replacement in our patient, we preferred valve repair to avoid complications related to lifelong anti-coagulation. This case report aims to present the congenital heart surgeon’s interpretation of valvular pathology in the adult patients. We believe that our case is unique in that VSD complicated both the semilunar valves insufficiency, limited the pulmonary overflow due to the prolapsus of these valves until adult ages.