Progression of Aortic Regurgitation After Subarterial Ventricular Septal Defect Repair: Optimal Timing of the Operation

AbstractIn patients with subarterial ventricular septal defect (VSD), the progression of aortic regurgitation (AR) still remains unclear. This review is to identify the incidence of AR progression after VSD repair and to determine the optimal operation timing for subarterial VSD repair with or without aortic valve prolapse or AR. From January 2002 to December 2015, 103 patients who underwent subarterial VSD repair alone at our hospital were reviewed. All patients routinely underwent echocardiography (echo) performed by our pediatric cardiologists. The operative approach was through the pulmonary artery in all patients. The median age of patients at operation was 10  months (range 3 to 16.5 months). Eighty-nine patients (86.4%) underwent subarterial VSD closure before the age of 4 years. In the preoperative evaluation, 27.2% (28 patients) of the patients showed more than faint degree AR. The mean follow-up duration after VSD repair was 6.6 ± 4.0 years. In the latest follow-up echo after VSD repair, four patients had more than mild degree AR owing to aortic valve abnormalities or delayed operation period. Among them, AR progression occurred in only one patient (0.98%). Early and accurate assessment of the anatomical morphology of the aortic valve and optimal operation timing may be important to achieve better outcomes after repair and to prevent the development of aortic valve complications.
Source: Pediatric Cardiology - Category: Cardiology Source Type: research

Related Links:

Publication date: Available online 17 September 2019Source: Journal of Cardiology CasesAuthor(s): Roberto Mijangos-Vázquez, Rogelio Hernández-Reyes, José R. López-JiménezAbstractGerbode defect is defined as an abnormal left ventricle–right atrium shunting which may have congenital or acquired origin, first described by Thurman in 1838, representing 0.08% of intracardiac shunts and
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research
Truncus arteriosus (TA) is a rare form of complex cyanotic congenital heart disease (CHD) (accounting for ∼2-4% of CHD lesions) where the pulmonary arteries (PAs), aorta and coronary arteries arise from a single great vessel.1,2 Complete surgical repair typically occurs in early infancy and involves PA reconstruction, insertion of a valved conduit or homograft between the right ventricular outflow tra ct (RVOT) and PAs, ventricular septal defect closure and, in some instances, repair or replacement of the native truncal valve.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Conclusions: Resection of subaortic membrane in children is associated with low mortality. Higher LVOT gradient, younger age at initial repair, and shorter valve-to-membrane distance were found to be associated with adverse outcome. Recurrence and reoperation rates are high, and progression of aortic insufficiency following subaortic membrane resection is common. Therefore, these patients warrant close follow-up into adult life.
Source: Annals of Pediatric Cardiology - Category: Cardiology Authors: Source Type: research
ConclusionsThe specific and exclusive shape of the MVA in patients with repaired AVSD was revealed in the patients studied, resulting in a loss of the saddle shape structure. Those results could help in the comprehension of anatomic changes of the mitral valve annulus occurring after AVSD surgery.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
ConclusionOur early results of modified Ross procedure are encouraging, however, long-term follow-up is required.
Source: Indian Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Abstract OBJECTIVES: Congenital heart defects (CHD) are still frequently missed in prenatal screening programs, which can result in severe morbidity or even death. This case-control study evaluated the original images of the second-trimester standard anomaly scan (SAS) images to explore reasons for a missed prenatal diagnosis. METHODS: All cases born with severe CHD in 2015-2016 were extracted from the PRECOR registry. Severe CHD was defined as requiring surgical repair in the first year of life. All cardiac views in the SAS (4CV, 3VV, LVOT, RVOT) were scored on technical correctness [range 0-5] by 2 fetal ec...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
Interrupted aortic arch is commonly associated with a posterior malalignment ventricular septal defect (VSD) and left ventricular outflow tract (LVOT) hypoplasia. Standard repair is carried out in the neonatal period and includes re-establishing arc continuity and VSD closure. Reintervention on the LVOT for obstruction is a common and an ongoing source of morbidity and mortality. A variety of preoperative echocardiographic measurements have been identified to identify patients at risk for developing LVOT obstruction but an aortic valve annulus dimension (mm)
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
Publication date: Available online 12 April 2019Source: The Annals of Thoracic SurgeryAuthor(s): Yuanjia Zhu, Jeffrey E. Cohen, Michael Ma, Y. Joseph WooAbstractA 28-year-old gentleman with ventricular septal defect (VSD), double-chambered right ventricle (DCRV) with associated right ventricular outflow tract obstruction, and anomalous right coronary artery (RCA) underwent resection of the DCRV, trans-aortic VSD repair, and unroofing of anomalous RCA. Two years later, he returned with delayed presentation of VSD flow funnel related aortic cusp prolapse and symptomatic severe aortic regurgitation. He underwent reoperative v...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Abstract A 28-year-old gentleman with ventricular septal defect (VSD), double-chambered right ventricle (DCRV) with associated right ventricular outflow tract obstruction, and anomalous right coronary artery (RCA) underwent resection of the DCRV, trans-aortic VSD repair, and unroofing of anomalous RCA. Two years later, he returned with delayed presentation of VSD flow funnel related aortic cusp prolapse and symptomatic severe aortic regurgitation. He underwent reoperative valve-sparing aortic root replacement and aortic cusp repair with an excellent outcome. PMID: 30986415 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
ConclusionSurgical simulation in cadaver models offer an opportunity for trainees to practice their surgical skills before entering operating room.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
More News: Cardiology | Gastroschisis Repair | Heart | Heart Valve Surgery | Hole in the Heart | Hospitals | Pediatrics | Ventricular Septal Defect