HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): John A. Hawkins Peter C. Kouretas Richard V. Williams Lloyd Y. Tani Linda M. Lambert Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hawkins, J. A. Articles by Minich, L. L. Search for Related Content PubMed PubMed Citation Articles by Hawkins, J. A. Articles by Minich, L. L. Related Collections Valve disease Related Article

J Thorac Cardiovasc Surg 2007;133:1311-1317
© 2007 The American Association for Thoracic Surgery

Surgery for Congenital Heart Disease

Intermediate-term results of repair for aortic, neoaortic, and truncal valve insufficiency in children

^a Division of Cardiothoracic Surgery, Departments of Surgery and Pediatrics, Primary Children’s Medical Center, and the University of Utah, Salt Lake City, Utah
^b Division of Cardiology, Departments of Surgery and Pediatrics, Primary Children’s Medical Center, and the University of Utah, Salt Lake City, Utah.

Presented at the Thirty-second Annual Meeting of the Western Thoracic Surgical Association, Sun Valley, Idaho, June 21-24, 2006.

Received for publication June 20, 2006; revisions received October 31, 2006; accepted for publication November 6, 2006.

^_* Address for reprints: John A. Hawkins, MD, Cardiothoracic Surgery, Primary Children’s Medical Center, 100 North Medical Drive, Salt Lake City, UT 84113. (Email: jhawkins{at}hsc.utah.edu).

Objective: Repair of aortic valve insufficiency is difficult, and durability is relatively unknown in children. This study evaluates the intermediate-term results of repair of the systemic semilunar valve, including the native aortic valve, neoaortic valve (anatomic pulmonary), and truncal valve.

Methods: We reviewed the records of 54 children (aged 2 days to 18 years) who underwent repair of the functional aortic valve for moderate or greater insufficiency from 1991 to 2005. Valve anatomy was tricuspid aortic in 26 patients, bicuspid aortic in 11 patients, tricuspid neoaortic in 9 patients, bicuspid neoaortic in 1 patient, and truncal valve in 7 patients. Multiple surgical techniques were used in most of the 54 patients, including leaflet plication in 17, leaflet repair in 15, commissuroplasty in 32, pericardial cusp augmentation in 8, and sinus of Valsalva reduction in 3.

Results: There was 1 early death and no late deaths. Actuarial freedom from reoperation was 68% at 5 years and 58% at 10 years. Freedom from aortic valve replacement was 82% at 5 years and 73% at 10 years. Duration of cardiopulmonary bypass was the most significant risk factor for reoperation with multivariate analysis. Of the 40 patients who have not undergone reoperation, 37 have had follow-up echocardiograms with the latest study (4.5 ± 4.2 years) demonstrating trace to 1+ insufficiency in 23 patients, 1 to 2+ in 12 patients, 2 to 3+ in 1 patient, and 3 to 4+ in 1 patient.

Conclusion: Repair of the insufficient systemic semilunar valve offers acceptable 10-year freedom from reoperation and functional results, and should be considered for most children.

Related Article

Discussion
J. Thorac. Cardiovasc. Surg. 2007 133: 1316-1317. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				E. A. Bacha, D. B. McElhinney, K. J. Guleserian, S. D. Colan, R. A. Jonas, P. J. del Nido, and G. R. Marx Surgical aortic valvuloplasty in children and adolescents with aortic regurgitation: Acute and intermediate effects on aortic valve function and left ventricular dimensions J. Thorac. Cardiovasc. Surg., March 1, 2008; 135(3): 552 - 559. [Abstract] [Full Text] [PDF]