Aortic valve repair. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2005:112-21
Date
04/09/2005Pubmed ID
15818366DOI
10.1053/j.pcsu.2005.01.013Scopus ID
2-s2.0-16444378736 (requires institutional sign-in at Scopus site) 19 CitationsAbstract
Aortic valve replacement options are limited in children, and all of them have disadvantages. Aortic valve repair techniques have evolved slowly and have not gained wide acceptance; however, large series using a variety of techniques demonstrate that valve repair is possible with excellent early hemodynamics and satisfactory intermediate durability. The results of aortic valve repair at the Children's Hospital of Wisconsin are presented. Simple repairs (blunt valvotomy, commissurotomy, or commissurotomy with leaflet thinning) directed at congenital aortic stenosis resulted in 86% +/- 5% freedom from reintervention at 10 years. Repair of aortic insufficiency with ventricular septal defect (VSD) resulted in 93.3% +/- 6% freedom from reoperation at 10 years. Complex repairs included a combination of techniques and yielded 5-year freedom from reintervention of 83% +/- 7% compared with 73% +/- 11% for patients undergoing aortic valve replacement (P = .62). Aortic valve repair provides an alternative to aortic valve replacement in selected patients. The utility of aortic valve repair and aortic valve replacement must be measured not only in freedom from reintervention but also in regression of left ventricular mass and exercise testing. Improvement in outcome depends on better patient selection and suitable bioprosthetic materials.
Author List
Tweddell JS, Pelech AN, Jaquiss RD, Frommelt PC, Mussatto KA, Hoffman GM, Litwin SBAuthors
Peter C. Frommelt MD Adjunct Professor in the Pediatrics department at Medical College of WisconsinGeorge M. Hoffman MD Chief, Professor in the Anesthesiology department at Medical College of Wisconsin
Kathleen Mussatto Ph.D. Associate Professor in the School of Nursing department at Milwaukee School of Engineering
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aortic Valve
Cardiac Surgical Procedures
Catheterization
Child
Child, Preschool
Follow-Up Studies
Heart Valve Diseases
Humans
Infant
Infant, Newborn
Patient Selection
Reoperation
Retrospective Studies
Treatment Outcome