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Neo-aortic insufficiency late after staged reconstruction for hypoplastic left heart syndrome: impact of differences in initial palliative procedures.
- Source :
-
Heart and vessels [Heart Vessels] 2019 Sep; Vol. 34 (9), pp. 1456-1463. Date of Electronic Publication: 2019 Mar 27. - Publication Year :
- 2019
-
Abstract
- The neo-aortic insufficiency in patients with hypoplastic left heart syndrome is an important sequela. We assessed the risks of the neo-aortic valve deterioration by the difference of initial palliations: Group I underwent primary Norwood (Nw) with systemic-to-pulmonary artery shunt (SPS), Group II underwent bilateral pulmonary artery banding (bPAB) and subsequent Nw with SPS (bPAB-Nw/SPS), Group III underwent bPAB and subsequent Nw with bidirectional Glenn (BDG) procedure (bPAB-Nw/BDG). The neo-aortic valve z score changes over time did not reach statistical significance in all groups (pā=ā0.43 for Group I, 0.20 for Group II, and 0.30 for Group III). The degree of neo-aortic valve insufficiency did not change significantly over time during this period except for Group III (pā=ā0.34 for Group I, 0.20 for Group II, and 0.02 for Group III). On the other hand, dimensions of the neo-aortic annulus and degrees of neo-aortic insufficiency did not differ significantly among the 3 groups at any pre-determined time. The presence or absence of incision into the sino-tubular junction at Nw did not affect the late neo-aortic valve z score or insufficiency. These data indicate that the difference of initial palliative procedures does not affect late neo-aortic valve insufficiency in Nw survivors. Because valve failure may develop in longer follow-up, further observation should be conducted.
- Subjects :
- Aortic Valve Insufficiency pathology
Echocardiography
Female
Fontan Procedure adverse effects
Humans
Infant
Infant, Newborn
Male
Norwood Procedures adverse effects
Pulmonary Artery surgery
Retrospective Studies
Risk Factors
Treatment Outcome
Aortic Valve Insufficiency diagnostic imaging
Hypoplastic Left Heart Syndrome surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1615-2573
- Volume :
- 34
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Heart and vessels
- Publication Type :
- Academic Journal
- Accession number :
- 30915524
- Full Text :
- https://doi.org/10.1007/s00380-019-01376-3