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Neo-aortic valvar function after the arterial switch.
Cardiol Young 2006; 16(5):481-9CY

Abstract

OBJECTIVES

The purpose of our study was to assess the prevalence and progression, during childhood and adolescence, of dilation of the neo-aortic root, and neo-aortic valvar regurgitation, and to identify risk factors for such dilation and regurgitation, after the arterial switch operation.

METHODS

We included all patients who had undergone an arterial switch operation at The Children's Hospital of Philadelphia, and had been followed for a minimum of 4 years, and had at least 2 postoperative echocardiograms. Neo-aortic valvar regurgitation was quantitatively assessed, and measurements were made of the neo-aortic root at the level of the basal attachment of the leaflets, mid-sinusal level, and the sinutubular junction.

RESULTS

We found 82 patients who satisfied the criterions for inclusion, of whom 52 patients had transposition with an intact ventricular septum, and 30 had either an associated ventricular septal defect or double outlet right ventricle. The median follow-up time was 8.8 years (4.1 to 16.4 years). The neo-aortic valve had been replaced in 1 patient. Of the patients, 3 had moderate, 66 had trivial to mild, and 12 had no neo-aortic valvar regurgitation at their most recent follow-up. The regurgitation had progressed by at least 1 grade in 38 of the 82 patients (46.4%). Neo-aortic dilation was noted at the basal attachment of the leaflets, and at mid-sinusal level, which was out of proportion to somatic growth.

CONCLUSIONS

At mid-term follow-up, significant neo-aortic valve regurgitation is present in 3.7%, and trivial to mild regurgitation in 81.4% of patients. The regurgitation progressed in almost half of the patients over time. We also noted progressive dilation of the neo-aortic root out of proportion to somatic growth.

Authors+Show Affiliations

Cardiac Center, Children's Hospital of Philadelphia and Department of Pediatrics, University of Pennsylvania School of Medicine, United States of America. marino@email.chop.edu

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16984700

Citation

Marino, Bradley S., et al. "Neo-aortic Valvar Function After the Arterial Switch." Cardiology in the Young, vol. 16, no. 5, 2006, pp. 481-9.
Marino BS, Wernovsky G, McElhinney DB, et al. Neo-aortic valvar function after the arterial switch. Cardiol Young. 2006;16(5):481-9.
Marino, B. S., Wernovsky, G., McElhinney, D. B., Jawad, A., Kreb, D. L., Mantel, S. F., ... Cohen, M. S. (2006). Neo-aortic valvar function after the arterial switch. Cardiology in the Young, 16(5), pp. 481-9.
Marino BS, et al. Neo-aortic Valvar Function After the Arterial Switch. Cardiol Young. 2006;16(5):481-9. PubMed PMID: 16984700.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neo-aortic valvar function after the arterial switch. AU - Marino,Bradley S, AU - Wernovsky,Gil, AU - McElhinney,Doff B, AU - Jawad,Abbas, AU - Kreb,Dieuwertje L, AU - Mantel,Suzan F, AU - van der Woerd,Wendy L, AU - Robbers-Visser,Danielle, AU - Novello,Rita, AU - Gaynor,J William, AU - Spray,Thomas L, AU - Cohen,Meryl S, PY - 2006/04/03/accepted PY - 2006/9/21/pubmed PY - 2007/1/11/medline PY - 2006/9/21/entrez SP - 481 EP - 9 JF - Cardiology in the young JO - Cardiol Young VL - 16 IS - 5 N2 - OBJECTIVES: The purpose of our study was to assess the prevalence and progression, during childhood and adolescence, of dilation of the neo-aortic root, and neo-aortic valvar regurgitation, and to identify risk factors for such dilation and regurgitation, after the arterial switch operation. METHODS: We included all patients who had undergone an arterial switch operation at The Children's Hospital of Philadelphia, and had been followed for a minimum of 4 years, and had at least 2 postoperative echocardiograms. Neo-aortic valvar regurgitation was quantitatively assessed, and measurements were made of the neo-aortic root at the level of the basal attachment of the leaflets, mid-sinusal level, and the sinutubular junction. RESULTS: We found 82 patients who satisfied the criterions for inclusion, of whom 52 patients had transposition with an intact ventricular septum, and 30 had either an associated ventricular septal defect or double outlet right ventricle. The median follow-up time was 8.8 years (4.1 to 16.4 years). The neo-aortic valve had been replaced in 1 patient. Of the patients, 3 had moderate, 66 had trivial to mild, and 12 had no neo-aortic valvar regurgitation at their most recent follow-up. The regurgitation had progressed by at least 1 grade in 38 of the 82 patients (46.4%). Neo-aortic dilation was noted at the basal attachment of the leaflets, and at mid-sinusal level, which was out of proportion to somatic growth. CONCLUSIONS: At mid-term follow-up, significant neo-aortic valve regurgitation is present in 3.7%, and trivial to mild regurgitation in 81.4% of patients. The regurgitation progressed in almost half of the patients over time. We also noted progressive dilation of the neo-aortic root out of proportion to somatic growth. SN - 1047-9511 UR - https://www.unboundmedicine.com/medline/citation/16984700/Neo_aortic_valvar_function_after_the_arterial_switch_ L2 - https://www.cambridge.org/core/product/identifier/S1047951106000953/type/journal_article DB - PRIME DP - Unbound Medicine ER -