Surgical repair of supracristal ventricular septal defect with combined multivalvular disease in an elderly patient: A transaortic approach

Uncorrected supracristal ventricular septal defect in an elderly patient is rare. We present elderly female with supracristal ventricular septal defect, chronic atrial fibrillation, and multivalvular disease. A transaortic approach enabled direct visualization and secure patch closure through the same aortotomy used for aortic valve replacement. Concomitant mitral valve replacement, tricuspid annuloplasty, and a Maze procedure with left atrial volume reduction were performed. This case demonstrates the transaortic approach as an effective strategy for combined ventricular septal defect and valve surgery in elderly patients.