Open AccessLong-term outcomes of aortic valve repair in children with congenital heart disease and their predictors
Author(s) -
Zufar Abdurakhmanov,
И.Н. Емец
Publication year - 2020
Publication title -
rossijskij kardiologičeskij žurnal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.141
H-Index - 14
eISSN - 2618-7620
pISSN - 1560-4071
DOI - 10.15829/1560-4071-2020-3971
Subject(s) - medicine , stenosis , aortic valve repair , regurgitation (circulation) , cardiology , surgery , commissurotomy , aortic valve , aorta , aortic root
Aim . To retrospectively analyze the long-term results of primary aortic valve repair (AVR) in children. Material and methods . The study included 163 patients operated on from 2004 to 2019. The mean age was 9,58±9,3 years. The patients underwent commissurotomy, decalcification, raphe resection, Trusler technique, raphe shaving, free margin plication, leaflet replacement, leaflet extension, subcommissural annuloplasty, valve sparing aortic root replacement and neocuspidization. Primary endpoint was a composite outcome of freedom from reoperation, recurrent greater than moderate aortic regurgitation, stenosis, whereas secondary — overall survival. Results . The indications for the procedure were stenotic, regurgitant or mixed defect in 80 (49,1%), 38 (23,3%), and 45 (27,6%) patients, respectively. The 10-year survival rate was 99,4%. The mean follow-up was 3,6±1,8 years. Freedom from reoperation, recurrent moderate and greater aortic regurgitation, stenosis at 1,5 and 7 years was, 95%, 70% and 47%, respectively. In multivariate analysis, Trusler technique, leaflet extension, raphe shaving, use of patch, leaflet retraction, complexity of repair were predictors for composite outcome. Conclusion . Reconstruction of aortic valve in children is effective and safe. Avoidance of predictors may significantly improve the long-term results of aortic valve repair.