The Impact of Aortic Valve Replacement on Left Ventricular Remodeling in Children. Pediatr Cardiol 2016 Aug;37(6):1022-7
Date
05/22/2016Pubmed ID
27206974DOI
10.1007/s00246-016-1383-xScopus ID
2-s2.0-84969834545 (requires institutional sign-in at Scopus site) 7 CitationsAbstract
There are scant data in pediatrics on the optimal timing for aortic valve repair (AVR). This study assesses the midterm response to AVR and possible predictors of poor outcome. From 2001 to 2006, 41 patients had greater than 3-month follow-up after AVR for aortic insufficiency, aortic stenosis, or both. Pre-, peri-, and post-operative data were collected, including demographics and clinical symptoms. Two reviewers measured echocardiographic parameters from the pre-operative and latest follow-up echocardiograms. Ventricular dimensions were indexed to body surface area (z-score). Median age at AVR was 13 years with 83 % having a Ross operation. The average left ventricular end-diastolic dimension pre-op, z-score of +1.3, significantly decreased at last follow-up to a mean z-score of -0.1 (p < 0.001). Similarly the indexed LV mass decreased from +3.9 to +0.5 (p < 0.001). There was no significant correlation between the presence of pre-op symptoms and the presence of post-op LV dilatation, hypertrophy, or dysfunction. In the subset of patients (7/41) with persistent LV dysfunction at last follow-up, there was a significant correlation with pre-op LV dilatation as assessed by both LVEDD (p = 0.02) and LVESD (p = 0.05). Children demonstrate significant reverse remodeling after AVR. Pre-op LV dilatation may predict patients with persistent LV dysfunction post-AVR. Symptoms are less useful in children, suggesting the need for more objective data for functional assessment.
Author List
Singh AK, Ungerleider RM, Law YMAuthor
Anoop K. Singh MD Associate Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAortic Valve
Aortic Valve Stenosis
Child
Heart Valve Prosthesis Implantation
Humans
Retrospective Studies
Treatment Outcome
Ventricular Function, Left
Ventricular Remodeling