Outcomes and Prognostic Factors for Adult Patients With Congenital Heart Disease Undergoing Primary or Reoperative Systemic Atrioventricular Valve Surgery

Han, Jiho; Ginns, Jonathan; Rosenbaum, Marlon; Chai, Paul J.; Bacha, Emile A.; Kalfa, David

doi:10.1177/2150135117692974

Cited by 5 publications

(7 citation statements)

References 21 publications

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“…The results of operations for valvular pathologies are very good in terms of survival and quality of life in the long term (39,40). This is not the case with surgery for end-stage CHD.…”

Section: Surgical Treatment Of End-stage Chdmentioning

confidence: 99%

Current spectrum, challenges and new developments in the surgical care of adults with congenital heart disease

Hörer

2018

Cardiovasc. Diagn. Ther

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Today, more than two thirds of patients with congenital heart disease (CHD) are adults. Cardiac surgery plays an essential role in restoring and maintaining cardiac function, aside from evolving medical treatment and catheter-based interventions. The aim of the present publication was to describe the spectrum of operations performed on adults with CHD (ACHD) by reviewing current literature. Currently, surgery for ACHD is predominantly valve surgery, since valvular pathologies are often either a part of the basic heart defect or develop as sequelae of corrective or palliative surgery. Surgical techniques for valve repair, established in patients with acquired heart disease (non-ACHD), can often be transferred to ACHD. New valve substitutes may help to reduce the number of redo operations. Most of valve operations yield good results in terms of survival and quality of life, with the precondition that the ventricular function is preserved. Heart failure due to end-stage CHD is the most frequent cause of mortality in ACHD. However, surgical treatment by means of mechanical circulatory support (MCS) is still uncommon and the mortality exceeds the one following other operations in ACHD. Currently, different devices are used and new technical developments are in progress. However, there still is no ideal assist device available. Therefore, heart transplantation remains the only valid option for end-stage CHD. Despite higher early mortality following heart transplantation in ACHD compared to non-ACHD, the long-term survival compares favorably to non-ACHD. There is room for improvement by refining the indications, the time of listing, and the perioperative care of ACHD transplant patients. Sudden death is the second most frequent cause of mortality in ACHD. Ventricular tachycardia is the most frequent cause of sudden death followed by coronary artery anomaly. Due to the increasing awareness of physicians and the improved imaging techniques, coronary artery anomalies are coming more into the focus of cardiac surgeons. However, the reported experience is limited and it is currently difficult to provide a standardized and generally applicable recommendation for the indication and the adequate surgical technique. With the increasing age and complexity of ACHD, treatment of rhythm disturbances by surgical ablation, pacemaker or implantable cardioverter defibrillator (ICD) implantation and resynchronisation gains importance. A risk score specifically designed for surgery in ACHD is among the newest developments in predicting the outcome of surgical treatment of ACHD. This evidence-based score, derived from and validated with data from the Society of Thoracic Surgeons Congenital Heart Surgery Database, enables comparison of risk-adjusted performance of the whole spectrum of procedures performed in ACHD and helps in understanding the differences in surgical outcomes. The score is thus a powerful tool for quality control and quality improvement. In conclusion, new developments in surgery for ACHD are currently made with regard to ...

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“…The results of operations for valvular pathologies are very good in terms of survival and quality of life in the long term (39,40). This is not the case with surgery for end-stage CHD.…”

Section: Surgical Treatment Of End-stage Chdmentioning

confidence: 99%

Current spectrum, challenges and new developments in the surgical care of adults with congenital heart disease

Hörer

2018

Cardiovasc. Diagn. Ther

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“…Surgical treatment: There are only a few reports that specifically address surgery for CCTGA in adults [ 14 , 40 - 43 ] . There is not a single approach that would be appropriate for all patients since the disease is rare and the specific anatomy and physiologic manifestations are highly variable.…”

Section: Managementmentioning

confidence: 99%

“…The most frequently performed operation is the tricuspid valve replacement in cases with more than moderate TR, either as an isolated procedure or at the time of intracardiac repair of other lesions [ 11 , 14 ] . The regurgitation is usually progressive, may lead to heart failure symptoms, valve repair is not advisable, and a mechanical or a bioprosthetic valve are the options available [ 14 , 15 , 40 , 42 , 43 ] . The interplay between the RV dysfunction and TR severity (which comes first?)…”

Section: Managementmentioning

confidence: 99%

“…Close follow-up is advisable with periodic evaluation of RV function since low mortality during valve replacement can be accomplished if ejection fraction is > 40% [ 44 ] . Good results are expected, and the risk factors for mortality or transplantation late after valve replacement included systemic RV fraction < 40%, atrial fibrillation, and nonsystemic ventricular systolic pressure > 50 mm/hg at the time of operation [ 42 , 43 , 45 ] .…”

Section: Managementmentioning

confidence: 99%

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Congenitally Corrected Transposition of the Great Arteries in the Adult

Amaral¹,

Valente²,

Manso³

et al. 2022

Braz J Cardiovasc Surg

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Introduction Congenitally corrected transposition of the great arteries (CCTGA) is a rare anomaly. Current data available regarding adult cases is derived from small series, information simultaneously presented in pediatric publications, and one classical multicenter study. This review, not aimed to exhaust the subject, has the purpose to examine the literature addressing presentation, diagnostic methodology, and management of afflicted adult patients. Methods A comprehensive search was undertaken in three major databases (PubMed, Cochrane, SciELO), using the keywords “congenitally corrected transposition of the great arteries” and “adults”. Relevant articles in English, Spanish, and Portuguese were extracted and critically appraised in this review. Steps for study selection were: (1) identification of titles of records through databases searching, (2) removal of duplicates, (3) screening and selection of abstracts, (4) final inclusion in the study. Results Four hundred sixty-five publications on CCTGA in adult patients were retrieved, and 166 were excluded; 299 studies were used for this review including 76 full-text articles, 70 studies related to general aspects of the subject, and, due to the small number of publications, 153 case reports. Sixty-one articles referring to combined experiences in pediatric and adult patients and judged to be relevant, but retrieved from another sources, were also included. Conclusion Albeit clinical presentation and diagnostic criteria have been well stablished, there seems to be room for discussion related to clinical and surgical management of CCTGA in adults. Considering the rarity of the disease, well designed multicenter studies may provide answers.

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“…After each extraction, centrifuge with a low-speed centrifuge and take the solution at the top to obtain a hydrochloric acid solution diluted with b FGF (total volume 20 ml). The absorbance of the sample (b FGF diluted hydrochloric acid solution) at 265 nm was measured with an ultraviolet spectrophotometer, and at the same time, the diluted hydrochloric acid solution hydrolyzed by nanoparticles without b FGF was used as a blank control (15). The absorbance value is substituted into the standard curve formula and the concentrationabsorbance standard curve to obtain the corresponding b FGF concentration.…”

Section: Experimental Testing Measuresmentioning

confidence: 99%

Effect of bFGF gel nano-sustained-release technology on rehabilitation effect of adult heart valve replacement

Huang

Wang

Cheng-yong

et al. 2022

Cell Mol Biol (Noisy-le-grand)

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the Due to the rapid improvement of economic level, aging and lifestyle changes, the incidence of valvular heart disease continues to increase, and the bFGF gel nano sustained-release technology plays an important role in the rehabilitation of adult heart valve replacement patients. The purpose of this article is to investigate the effect of bFGF gel nano-slow release technology on the rehabilitation effect of adult heart valve replacement patients. The research object was selected from all cases of valve replacement surgery from January 2019 to January 2020, and 216 patients were divided into experimental group and control group, the experimental group carried out the sustained release of bFGF gel nanospheres. The experimental group was 49.76±8.13 years old, including 94 cases of rheumatic heart disease, 13 cases of degenerative valvular disease, and 3 cases of congenital valvular disease, a total of 110 cases. Heart performance tests were performed respectively. The results showed that the incidence of atrial fibrillation, left ventricular hypertrophy and ST-segment depression of 0.1m V in the experimental group were 32.19%, 34.48%, and 19.84%, while the corresponding data in the control group were 62.78%, 52.07%, and 45.87%. It can be seen that bFGF gel nano sustained-release technology is of great significance for the rehabilitation of adult heart valve replacement patients.

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Outcomes and Prognostic Factors for Adult Patients With Congenital Heart Disease Undergoing Primary or Reoperative Systemic Atrioventricular Valve Surgery

Abstract: Overall outcomes in this challenging population are good. The single factor associated with adverse events was predischarge SAVV regurgitation grade.

Cited by 5 publications

References 21 publications

Current spectrum, challenges and new developments in the surgical care of adults with congenital heart disease

Current spectrum, challenges and new developments in the surgical care of adults with congenital heart disease

Congenitally Corrected Transposition of the Great Arteries in the Adult

Effect of bFGF gel nano-sustained-release technology on rehabilitation effect of adult heart valve replacement

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