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Neo-aortic insufficiency late after staged reconstruction for hypoplastic left heart syndrome: impact of differences in initial palliative procedures.

Authors :
Umezu K
Harada Y
Sakamoto T
Okamura T
Shintomi S
Takigiku K
Yasukochi S
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€‰=ā€‰0.43 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€‰=ā€‰0.34 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.

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