Document Detail


Aortic valve repair.
MedLine Citation:
PMID:  15818366     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Aortic valve replacement options are limited in children, and all of them have disadvantages. Aortic valve repair techniques have evolved slowly and have not gained wide acceptance; however, large series using a variety of techniques demonstrate that valve repair is possible with excellent early hemodynamics and satisfactory intermediate durability. The results of aortic valve repair at the Children's Hospital of Wisconsin are presented. Simple repairs (blunt valvotomy, commissurotomy, or commissurotomy with leaflet thinning) directed at congenital aortic stenosis resulted in 86% +/- 5% freedom from reintervention at 10 years. Repair of aortic insufficiency with ventricular septal defect (VSD) resulted in 93.3% +/- 6% freedom from reoperation at 10 years. Complex repairs included a combination of techniques and yielded 5-year freedom from reintervention of 83% +/- 7% compared with 73% +/- 11% for patients undergoing aortic valve replacement (P = .62). Aortic valve repair provides an alternative to aortic valve replacement in selected patients. The utility of aortic valve repair and aortic valve replacement must be measured not only in freedom from reintervention but also in regression of left ventricular mass and exercise testing. Improvement in outcome depends on better patient selection and suitable bioprosthetic materials.
Authors:
James S Tweddell; Andrew N Pelech; Robert D B Jaquiss; Peter C Frommelt; Kathleen A Mussatto; George M Hoffman; S Bert Litwin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in thoracic and cardiovascular surgery. Pediatric cardiac surgery annual     Volume:  -     ISSN:  1092-9126     ISO Abbreviation:  Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu     Publication Date:  2005  
Date Detail:
Created Date:  2005-04-08     Completed Date:  2005-09-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815944     Medline TA:  Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu     Country:  United States    
Other Details:
Languages:  eng     Pagination:  112-21     Citation Subset:  IM    
Affiliation:
Division of Cardiothoracic Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee 53226, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aortic Valve / surgery*
Balloon Dilatation
Cardiac Surgical Procedures / methods*
Child
Child, Preschool
Follow-Up Studies
Heart Valve Diseases / complications,  surgery*
Humans
Infant
Infant, Newborn
Patient Selection
Reoperation
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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