Document Detail


Aortic valve regurgitation after arterial switch operation for transposition of the great arteries: incidence, risk factors, and outcome.
MedLine Citation:
PMID:  16697325     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aims of this study were to assess the prevalence and incidence of aortic valve regurgitation (AR) after arterial switch operation (ASO), its outcome, and the risk factors. BACKGROUND: After an ASO, the long-term fate of the aortic valve is a concern as follow-up lengthens. METHODS: Operative and follow-up data on 1,156 hospital survivors after ASOs between 1982 and December 2000 were reviewed. RESULTS: At last follow-up (mean duration 76.2 +/- 60.5 months), 172 patients (14.9%) had an AR. Complex transposition of the great arteries, prior pulmonary banding done in 75 patients (21 with intact ventricular septum), aortic arch anomalies, AR at discharge, older age at ASO, and aortic/pulmonary size discrepancy were associated with AR. On multivariate analysis, the presence of a ventricular septal defect (VSD) or AR at discharge multiplied the risk by 2 and 4, respectively. Freedom from AR was 77.9% and 69.5% at 10 and 15 years, respectively; hazard function for AR declined rapidly and slowly increased thereafter. Reoperation from AR was done in 16 patients with one death, valvuloplasty being unsuccessful. Freedom from reoperation for AR was 97.7% and 96.8% at 10 and 15 years, respectively; hazard function slowly increased from 2 to 16 years. Higher late mortality was not associated with AR. CONCLUSIONS: After ASO, AR was observed and was related to VSD with attending high pressure and flow and AR at discharge. Progression of AR was slow, but incidence increased with follow-up. Reoperation for AR was rare. Late aortic valve function warrants long-term monitoring.
Authors:
Jean Losay; Anita Touchot; Andre Capderou; Jean-Dominique Piot; Emre Belli; Claude Planché; Alain Serraf
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Publication Detail:
Type:  Journal Article     Date:  2006-04-27
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  47     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-15     Completed Date:  2006-05-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2057-62     Citation Subset:  AIM; IM    
Affiliation:
Centre Chirurgical Marie-Lannelongue, Le Plessis-Robinson, France. jlosay@ccml.fr
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MeSH Terms
Descriptor/Qualifier:
Aorta / surgery
Aortic Valve Insufficiency / epidemiology*,  etiology
Cardiovascular Abnormalities / complications,  surgery
Cardiovascular Surgical Procedures / adverse effects*
Coronary Vessels / surgery
Follow-Up Studies
Heart Septal Defects, Ventricular / complications*
Humans
Incidence
Infant
Infant, Newborn
Prevalence
Proportional Hazards Models
Pulmonary Artery / surgery
Retrospective Studies
Risk Factors
Survival Analysis
Transposition of Great Vessels / complications,  surgery*
Treatment Outcome
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2006 May 16;47(10):2063-4   [PMID:  16697326 ]

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