Aortic Valve Repair in Pediatric Patients: 30 Years Single Center Experience

Schlein, Johanna; Kaider, Alexandra; Gabriel, Harald; Wiedemann, Dominik; Hornykewycz, Stephan; Simon, Paul; Base, Eva; Michel‐Behnke, Ina; Laufer, Günther; Zimpfer, Daniel

doi:10.1016/j.athoracsur.2022.05.061

Cited by 8 publications

(8 citation statements)

References 21 publications

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“…In accordance with the previous report (7,8,22), we showed that a small aortic annulus was associated with mortality and adverse event. Although aortic annulus size is not a risk factor for reintervention in the competing risk model, we considered it to imply a poor outcome.…”

Section: Reintervention and Adverse Eventsupporting

confidence: 93%

“…In our study, early mortality and late mortality were 5.3% (4/75) and 5.6% (4/71), respectively. Similarly, Schlein et al (7) reported that early mortality and late mortality were 5.6 and 6.7%, respectively. Furthermore, in patients with isolated AS, survival was much higher.…”

Section: Mortalitymentioning

confidence: 82%

“…Similarly, Reich et al ( 23 ) demonstrated that hypoplastic annulus increases the risk of both BAV and AoV repair. Additionally, Schlein et al argued that aortic annulus size and mitral valve condition determine the prognosis for patients who underwent AoV repair ( 7 , 8 ). Our study demonstrated that primary AoV repair achieves superior survival in patients with an AoV annulus diameter Z -score ≥0.745 and freedom from adverse event in patients with an AoV annulus diameter Z -score≥–1.26.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have investigated the long-term outcomes in children who underwent AoV repair and have reported that the reintervention rate at 10 years was 27.9-47.9% (1,(7)(8)(9)(10). Therefore, screening out the potential high-risk group for adverse events is essential for enhancing the follow-up of this group of patients and intervening in time.…”

Section: Introductionmentioning

confidence: 99%

“…Most studies included patients who had undergone surgical aortic valvulotomy or balloon aortic valvuloplasty, which may impact prognosis after AoV repair. Furthermore, only one study used a competing risk regression model to analyze risk factors ( 7 ). We excluded patients who had undergone AoV intervention and used a competing risk regression model to determine the risk factors for reintervention and replacement.…”

Section: Introductionmentioning

confidence: 99%

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Long-term outcomes of primary aortic valve repair in children with congenital aortic stenosis – 15-year experience at a single center

Ren

Yu²,

Chen³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundStudies on the long-term outcomes of children with congenital aortic stenosis who underwent primary aortic repair are limited. We reviewed the long-term outcomes of children who underwent aortic valve (AoV) repair at our center.MethodsAll children (n = 75) who underwent AoV repair between 2006 and 2020 were reviewed. The Kaplan-Meier curve was used to demonstrate the survival estimates. The Cox proportional hazard model and competing risk regression model were used to identify risk factors for death, reintervention, adverse events, and replacement.ResultsThe median age at surgery was 1.8 (IQR, 0.2–7.7) years, and the median weight at surgery was 10.0 (IQR, 5.0–24.0) kg. Early mortality and late mortality were 5.3% (4/75) and 5.6% (4/71), respectively. Risk factors for overall mortality were concomitant mitral stenosis (P = 0.01, HR: 9.8, 95% CI: 1.8–53.9), low AoV annulus Z-score (P = 0.01, HR: 0.6, 95% CI: 0.4–0.9), and prolonged cardiopulmonary bypass time (P < 0.01, HR: 9.5, 95% CI: 1.7–52.1). Freedom from reintervention was 72.9 ± 0.10% (95% CI: 56.3–94.4%) at 10 years. Risk factors for occurrence of adverse event on multivariable analysis included preoperative intubation (P = 0.016, HR: 1.004, 95% CI: 1.001–1.007) and a low AoV annulus Z-score (P = 0.019, HR: 0.714, 95% CI: 0.540–0.945). Tricuspid AoV morphology was associated with a suboptimal postoperative outcome (P = 0.03).ConclusionAortic valve repair remains a safe and durable solution for children with congenital aortic stenosis. Concomitant mitral stenosis and aortic valve anatomy, including tricuspid valve morphology and smaller annulus size, are associated with poor early and long-term outcomes.

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Section: Reintervention and Adverse Eventsupporting

confidence: 93%

Section: Mortalitymentioning

confidence: 82%