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Low incidence of significant valvar insufficiency following retrograde aortic radiofrequency catheter ablation in young patients.
J Interv Card Electrophysiol 1999; 3(2):181-5JI

Abstract

The incidence of significant valvar insufficiency at late (<6 month) follow-up was retrospectively evaluated in 27 young patients (age 4. 0-18.0 years) undergoing 29 ablation procedures via the retrograde aortic approach for left-sided accessory connections in whom pre-ablation and post-ablation echocardiograms were available for review. Valvar insufficiency was graded using color flow techniques as absent, trivial, mild, moderate, or severe by blinded reviewers. Ablation was acutely successful via the retrograde approach in 25 of 29 procedures among these 27 patients. Successful ablation was ultimately achieved in all 27 patients. At baseline, 7 patients had evidence of trivial or mild mitral insufficiency, and no patient had aortic insufficiency. Three patients had evidence of impaired left ventricular systolic performance in the presence of manifest pre-excitation. At follow-up, pre-existing mitral insufficiency resolved in 5/7 patients, and persisted in 2 patients. New mitral insufficiency was evident in 3 patients, and new aortic insufficiency was transiently evident in 1 patient following ablation (all trivial). Institutional experience (mean rank 10 cases vs. 33 cases, p <.0005), and lower patient weight (29.7 vs. 56.3 kilograms, p =.01) were the only factors associated with the development of new valvar insufficiency. Valvar insufficiency could not be detected by careful auscultation in any patient and was deemed clinically insignificant in all patients. We conclude that ablation of left-sided accessory connections can be performed via the retrograde aortic approach without creating clinically significant valvar insufficiency.

Authors+Show Affiliations

Vanderbilt University Medical Center, Division of Pediatric Cardiology, Nashville, Tennessee 37232, USA. patrick.frias@mcmail. vanderbilt.edu.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10387135

Citation

Frias, P A., et al. "Low Incidence of Significant Valvar Insufficiency Following Retrograde Aortic Radiofrequency Catheter Ablation in Young Patients." Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing, vol. 3, no. 2, 1999, pp. 181-5.
Frias PA, Taylor MB, Kavanaugh-McHugh A, et al. Low incidence of significant valvar insufficiency following retrograde aortic radiofrequency catheter ablation in young patients. J Interv Card Electrophysiol. 1999;3(2):181-5.
Frias, P. A., Taylor, M. B., Kavanaugh-McHugh, A., & Fish, F. A. (1999). Low incidence of significant valvar insufficiency following retrograde aortic radiofrequency catheter ablation in young patients. Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing, 3(2), pp. 181-5.
Frias PA, et al. Low Incidence of Significant Valvar Insufficiency Following Retrograde Aortic Radiofrequency Catheter Ablation in Young Patients. J Interv Card Electrophysiol. 1999;3(2):181-5. PubMed PMID: 10387135.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low incidence of significant valvar insufficiency following retrograde aortic radiofrequency catheter ablation in young patients. AU - Frias,P A, AU - Taylor,M B, AU - Kavanaugh-McHugh,A, AU - Fish,F A, PY - 1999/7/1/pubmed PY - 1999/7/1/medline PY - 1999/7/1/entrez SP - 181 EP - 5 JF - Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing JO - J Interv Card Electrophysiol VL - 3 IS - 2 N2 - The incidence of significant valvar insufficiency at late (<6 month) follow-up was retrospectively evaluated in 27 young patients (age 4. 0-18.0 years) undergoing 29 ablation procedures via the retrograde aortic approach for left-sided accessory connections in whom pre-ablation and post-ablation echocardiograms were available for review. Valvar insufficiency was graded using color flow techniques as absent, trivial, mild, moderate, or severe by blinded reviewers. Ablation was acutely successful via the retrograde approach in 25 of 29 procedures among these 27 patients. Successful ablation was ultimately achieved in all 27 patients. At baseline, 7 patients had evidence of trivial or mild mitral insufficiency, and no patient had aortic insufficiency. Three patients had evidence of impaired left ventricular systolic performance in the presence of manifest pre-excitation. At follow-up, pre-existing mitral insufficiency resolved in 5/7 patients, and persisted in 2 patients. New mitral insufficiency was evident in 3 patients, and new aortic insufficiency was transiently evident in 1 patient following ablation (all trivial). Institutional experience (mean rank 10 cases vs. 33 cases, p <.0005), and lower patient weight (29.7 vs. 56.3 kilograms, p =.01) were the only factors associated with the development of new valvar insufficiency. Valvar insufficiency could not be detected by careful auscultation in any patient and was deemed clinically insignificant in all patients. We conclude that ablation of left-sided accessory connections can be performed via the retrograde aortic approach without creating clinically significant valvar insufficiency. SN - 1383-875X UR - https://www.unboundmedicine.com/medline/citation/10387135/Low_incidence_of_significant_valvar_insufficiency_following_retrograde_aortic_radiofrequency_catheter_ablation_in_young_patients_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=10387135.ui DB - PRIME DP - Unbound Medicine ER -