Document Detail


Neoaortic bicuspid valve in arterial switch operation: mid-term follow-up.
MedLine Citation:
PMID:  18154805     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We sought to identify the prevalence of bicuspid pulmonary valve among patients with transposition of the great arteries undergoing the arterial switch operation and evaluate functional integrity of that valve in the neoaortic position. METHODS: Between October 1985 and December 2001, 391 patients had an arterial switch operation for transposition and its variants. Perioperative information and follow-up data were available for 342 patients. The serial echocardiograms of patients with bicuspid pulmonary valve were reviewed. The neoaortic valve was serially assessed, focusing on aortic insufficiency, annulus diameter, and pressure gradients. RESULTS: Twenty-four patients (7%) had a bicuspid pulmonary valve. Age at operation was 5 days to 12 years. Two patients were lost to follow up, and 22 patients had mean follow-up of 5.3 years (range, 2 months to 13 years), of which 21 patients were alive and 1 died late. At least two postoperative echocardiogram reports were available on 19 patients. Seven patients had no neoaortic regurgitation, and 10 had trivial regurgitation. Severe aortic regurgitation developed in 1 patient with endocarditis and in another with repair of Taussig-Bing anomaly. Neoaortic valve size indexed to body surface area showed an increase in annular diameter over time proportional to somatic growth. No significant valve stenosis developed. CONCLUSIONS: Encountering a bicuspid pulmonary valve at the time of an arterial switch operation is not uncommon. The integrity of a bicuspid pulmonary valve in the neoaortic position is maintained at a mean follow-up of 5.3 years. We believe that the presence of a bicuspid pulmonary valve is not a contraindication to an arterial switch operation.
Authors:
Shahid M Khan; Ahmad Bin Sallehuddin; Ziad R Al-Bulbul; Zohair Y Al-Halees
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  85     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-24     Completed Date:  2008-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  179-84     Citation Subset:  AIM; IM    
Affiliation:
King Faisal Heart Institute, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple / diagnosis,  epidemiology
Analysis of Variance
Aortic Valve Insufficiency / epidemiology*,  ultrasonography
Cardiac Surgical Procedures / adverse effects,  methods*
Child
Child, Preschool
Cohort Studies
Echocardiography, Doppler
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Male
Mitral Valve / abnormalities*,  ultrasonography
Prevalence
Probability
Pulmonary Valve / abnormalities*,  ultrasonography
Retrospective Studies
Risk Assessment
Survival Rate
Time Factors
Transposition of Great Vessels / diagnosis,  mortality,  surgery*
Treatment Outcome
Comments/Corrections
Comment In:
Ann Thorac Surg. 2008 Jan;85(1):184-5   [PMID:  18154806 ]

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