Ventricular septal defect as an uncommon complication following mechanical aortic valve replacement

Abstract

Although there is a long list of possible complications following aortic valve replacement, interventricular septal lesions are exceptional. A case is presented of a 24-year-old patient with arterial hypertension secondary to aortic coarctation, bicuspid aortic valve with mild regurgitation, and atrial septal defect, who underwent closure of the shunt with an Amplatzer device and aortic stent in 2018. In 2023, the patient developed severe aortic regurgitation and underwent mechanical valve replacement. The surgery was complicated by ventricular fibrillation and postoperative bleeding. During follow-up, a double murmur was auscultated, one corresponding to the prosthesis and another holosystolic, harsh at the Erb's point. An echocardiogram revealed perimembranous ventricular septal defect.