Midterm Results of Repair of Perimembranous or Conal Ventricular Septal Defects Using the Transaortic Direct Suture Technique

This surgical technique does not prevent progressive aortic valve dysfunction, which may be related to structural deficiency of the valve leaflet or distortion of the annulus by direct suture closure of the ventricular septal defect. Early closure may prevent structural leaflet damage, whereas adaptation of the transaortic technique to include a shallow ventricular septal defect patch may be beneficial in older patients.