Reply to Poullis

We appreciate the letter by Poullis [1] regarding our case report on ventricular septal defect following mitral valve replacement [2]. The author presents an interesting alternate potential cause, highlighting a case where the valve strut eroded through the ventricular septum. This is certainly a possible aetiology to consider in this rare complication.

However, we do not think this aetiology was responsible in our specific case. All the cardiac images clearly demonstrate that the valve struts are not near the septum, as opposed to the case highlighted by the author wherein the valve struts are noted to be in very close proximity to the septum. Regardless, this possibility should be looked for whenever a ventricular septal defect occurs following mitral valve replacement.

REFERENCES