Document Detail


Atrioventricular valve repair in patients with functional single ventricle.
MedLine Citation:
PMID:  20584537     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We aimed to evaluate surgical repair of atrioventricular valve regurgitation in patients with functional single ventricle. METHODS: The medical records of 65 consecutive patients with functional single ventricle who underwent atrioventricular valve repair between January 1999 and October 2008 were reviewed retrospectively. Their characteristics were as follows: median age, 9.5 months; median weight, 6.0 kg; atrial isomerism, 31 patients; and hypoplastic left heart syndrome, 12 patients. Regurgitation was repaired at the palliative, Glenn, and Fontan stage in 21, 29, and 15 patients, respectively. RESULTS: The overall survival was 79% and 70% at 1 and 5 years, respectively. The risk factors for mortality were age less than 3 months (P < .001), body weight less than 4 kg (P < .001), hypoplastic left heart syndrome (P = .001), concomitant Norwood (P < .001), and the palliative stage (P = .004) on the univariate analysis, and body weight less than 4 kg (P = .010, hazard ratio, 9.8; 95% confidence interval, 1.7-55.6) on the multivariate analysis. Twenty patients underwent reoperation (repairs in 15; replacements in 5), and freedom from reoperation at 1 and 5 years was 69% and 57%, respectively. Concomitant systemic-to-pulmonary shunt (P = .040) was a risk factor for reoperation on the univariate analysis. Of the 48 survivors, 38 underwent Fontan completion, 7 underwent the Glenn procedure, and 3 are awaiting the Glenn procedure. CONCLUSIONS: The midterm results of atrioventricular valve repair in patients with functional single ventricle were favorable; however, young and small patients, especially those with hypoplastic left heart syndrome, still had poor outcomes.
Authors:
Tomohiro Nakata; Yoshifumi Fujimoto; Keiichi Hirose; Yuko Tosaka; Yujiro Ide; Maiko Tachi; Kisaburo Sakamoto
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Publication Detail:
Type:  Journal Article     Date:  2010-06-26
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  140     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-20     Completed Date:  2010-09-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  514-21     Citation Subset:  AIM; IM    
Copyright Information:
2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Body Weight
Cardiac Surgical Procedures* / adverse effects,  mortality
Chi-Square Distribution
Child, Preschool
Female
Fontan Procedure
Heart Defects, Congenital / complications,  mortality,  surgery*
Heart Valve Diseases / etiology,  mortality,  surgery*
Humans
Hypoplastic Left Heart Syndrome / complications,  surgery
Infant
Infant, Newborn
Kaplan-Meiers Estimate
Male
Palliative Care
Proportional Hazards Models
Reoperation
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome

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


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