Impact of Aortic Annular Size on Rate of Reoperation for Left Ventricular Outflow Tract Obstruction After Repair of Interrupted Aortic Arch and Ventricular Septal Defect

Hirata, Yasutaka; Quaegebeur, Jan M.; Mosca, Ralph S.; Takayama, Hiroo; Chen, Jonathan M.

doi:10.1016/j.athoracsur.2010.04.065

Cited by 43 publications

(35 citation statements)

References 15 publications

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“…In our study, the sinotubular junction size was also an independent risk factor for intervention for LVOTO among the primary repair group and reintervention in the entire group. Although, we found a significant difference in aortic valve annulus size between the primary and Yasui operation groups, aortic valve annulus size was not found to be an independent predictor of LVOTO as previously reported . Our findings would advocate that aortic root size rather than the aortic valve annulus size may be more predictive of need for reoperation.…”

Section: Discussionsupporting

confidence: 48%

“…Although, we found a significant difference in aortic valve annulus size between the primary and Yasui operation groups, aortic valve annulus size was not found to be an independent predictor of LVOTO as previously reported. 12,21 Our findings would advocate that aortic root size rather than the aortic valve annulus size may be more predictive of need for reoperation.…”

Section: Discussionmentioning

confidence: 80%

“…These guidelines have been inferred from either preoperative findings associated with subsequent development of LVOTO following primary repair of IAA or are based on institutional practices and surgeon preference. A study from Hirata et al on analysis of 38 patients found that the reoperation rate for LVOTO was low if the patient had an aortic valve annulus greater than the patient's weight (kg) + 1.5 mm; but if a patient's aortic valve was less than the patient's weight + 1.5 mm, then nearly half required a reoperation. From this small study, it was recommended, that a LVOT bypass procedure should be considered if the aortic annulus is less than the patient's weight + 1.0 mm.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative echocardiographic measures in interrupted aortic arch: Which ones best predict surgical approach and outcome?

Abarbanell

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Schlosser

et al. 2018

Congenital Heart Disease

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Neonates with IAA and an aortic root z-score less than -2.5 have lower odds of subsequent reoperations with a Yasui operation compared to a primary repair over the follow up period. These findings suggest a Yasui operation should be considered if the preoperative aortic root z-score is less than -2.5. Careful evaluation of these morphologic predictors on preoperative echocardiograms can be helpful in surgical planning in neonates with IAA.

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Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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Preoperative echocardiographic measures in interrupted aortic arch: Which ones best predict surgical approach and outcome?

Abarbanell

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Schlosser

et al. 2018

Congenital Heart Disease

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“…We report data on survivors and cannot comment on how mortality in our cohort compares with previous studies. Operative re-intervention rates have been assessed[3, 4, 6] with 29% of surviving patients undergoing re-intervention on their aortic arch by 15 years (with mortality prior to arch re-intervention of 32%), and 18% required LVOT interventions over 15 years of follow-up (with mortality prior to LVOT re-intervention of 33%)[6]. Our re-intervention rates on LVOT (33%), the aortic arch (38%), or both (24%) were similar.…”

Section: Discussionmentioning

confidence: 99%

Morbidity in Children and Adolescents After Surgical Correction of Interrupted Aortic Arch

et al. 2013

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Background Previous studies of outcome following operative correction of interrupted aortic arch (IAA) focus on mortality and rates of re-intervention. We sought to investigate the clinical status of children and adolescents following surgery for interrupted aortic arch (IAA). Methods A cross-sectional study of subjects with IAA between the ages of 8-18 years was performed with subject undergoing concurrent genetic testing, electrocardiogram, cardiac magnetic resonance imaging, cardiopulmonary exercise testing, and assessment of health status and health-related quality of life as well as concurrent retrospective cohort study reviewing their post-operative utilization of medical care including operative and trans-catheter reintervention, non-cardiac operations, and hospitalizations. Results 21 subjects with IAA with median age of 9 years were studied. Re-intervention rates were 38% on the left ventricular outflow tract, 33% for the aortic arch, and 24% for both. Rates of re-intervention were highest in the first year of life and decreased in subsequent years. Left ventricular ejection fraction was preserved (72±6%). Maximal oxygen consumption, maximal work, and forced vital capacity were both significantly diminished from age and gender norms (p<0.0001). Health status and quality of life were both severely diminished. Conclusion Subjects with IAA demonstrate a significant burden of operative and trans-catheter intervention and large magnitude deficits in exercise performance, health status, and health related quality of life.

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“…Patients with annular diameters (in millimeters) smaller than the patient's weight (in kilograms) are deemed at high risk for recurrent obstruction. 7,8 But even in patients with aortic annular dimensions (in millimeters) larger than body weight (in kilograms) þ 1 mm, who additionally show deviation of the conal septum, the rate of reoperation remains strikingly high. 8 Addressing the conal malalignment is therefore an essential component in achieving enduring relief of the obstruction.…”

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confidence: 99%

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Haller

2017

The Journal of Thoracic and Cardiovascular Surgery

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Impact of Aortic Annular Size on Rate of Reoperation for Left Ventricular Outflow Tract Obstruction After Repair of Interrupted Aortic Arch and Ventricular Septal Defect

Cited by 43 publications

References 15 publications

Preoperative echocardiographic measures in interrupted aortic arch: Which ones best predict surgical approach and outcome?

Preoperative echocardiographic measures in interrupted aortic arch: Which ones best predict surgical approach and outcome?

Morbidity in Children and Adolescents After Surgical Correction of Interrupted Aortic Arch

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