1. Does Coronary Reimplantation After Neoaortic Reconstruction Increase Aortic Regurgitation?
- Author
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Joung-Hee Byun, Hyoung Doo Lee, Young Seok Lee, Hyungtae Kim, Hoon Ko, Geena Kim, Si Chan Sung, and Kwang Ho Choi
- Subjects
Male ,Aortic valve ,medicine.medical_specialty ,Transposition of Great Vessels ,Aortic Valve Insufficiency ,Regurgitation (circulation) ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,medicine ,Humans ,Aortic valve regurgitation ,Retrospective Studies ,business.industry ,Incidence ,Incidence (epidemiology) ,Medical record ,Infant, Newborn ,Infant ,Vascular surgery ,medicine.disease ,Coronary Vessels ,Surgery ,Cardiac surgery ,Arterial Switch Operation ,Coronary artery anatomy ,medicine.anatomical_structure ,030228 respiratory system ,Aortic Valve ,Replantation ,Pediatrics, Perinatology and Child Health ,Female ,Cardiology and Cardiovascular Medicine ,business ,Dilatation, Pathologic ,Follow-Up Studies - Abstract
Coronary reimplantation after neoaortic reconstruction (CRANR) in the arterial switch operation (ASO) allows easy selection of accurate coronary transfer sites in the distended neoaorta. However, neoaortic valve injury may occur during coronary reimplantation. We determined whether the CRANR procedure increased the incidence of aortic valve regurgitation (AR) after ASO. Between March 1994 and August 2017, 227 patients underwent ASO. Since September 2000 CRANR has been performed on 155 patients and open coronary reimplantation (OCR) on 72. Patients who had undergone aortocoronary flaps procedures (n = 13), had early or late mortality (n = 27), or lacked data (n = 11) were excluded. We enrolled and retrospectively reviewed the medical records of 176 patients who were followed up for postoperative AR: 38 underwent OCR and 138 underwent CRANR. We compared the incidences of early and late postoperative AR in both groups. We defined mild or greater AR as "significant AR." The groups did not differ in body weight at operation, great artery relationship, and coronary artery anatomy. The incidences of significant AR at discharge were 21.1% (8/38) in the OCR group and 16.6% (23/138) in the CRANR group (p = 0.53). The freedom from significant AR at 5 years was 59.9% in the OCR group and 62.4% in the CRANR group with no difference between the two groups (p = 0.73). Moderate AR occurred in one patient in the CRANR group. No surgical intervention was required for the aortic valve in either group. ASO using the CRANR technique did not increase the incidence of postoperative early and late AR.
- Published
- 2019
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