JOURNAL ARTICLE

Predictors of left ventricular remodeling after aortic valve replacement in pediatric patients with isolated aortic regurgitation

Sujatha Buddhe, Wei Du, Henry L Walters, Ralph Delius, Michael D Pettersen
Congenital Heart Disease 2013, 8 (2): 167-73
22931553

OBJECTIVE: To identify the risk factors that could predict postoperative outcome after aortic valve replacement in pediatric patients with isolated aortic regurgitation (AR).

BACKGROUND: There is controversy regarding the appropriate timing of surgery in asymptomatic or minimally symptomatic patients with isolated AR. In the pediatric age group, there are limited studies in this regard and most of them are on combined aortic valve stenosis and regurgitation.

METHODS: All patients with biventricular physiology and morphologic left ventricle (LV) who underwent aortic valve surgery for AR from January 1988 to July 2010 were included in the study. Demographic, clinical, and echocardiographic data were collected at presurgical visit, early postoperative, 1 year, and most recent follow-up.

RESULTS: Among 53 patients (36 males), 18 had LV end-diastolic diameter (LVEDD) z-score >4 standard deviation (SD) (group I) and 35 had LVEDD <4 SD (group II). Forty-one had long-term follow-up. Mean age at surgery was 11.6 ± 5.9 years; mean follow-up was 6.9 ± 5.6 years. Preoperative LVEDD >4 SD predicted persistent LV dilation (>2 SD) at early post-op (P < .05) and 1 year follow-up (P = .09). Preoperative decreased LV function (fractional shortening <28%) was the only significant predictor of persistent LV dysfunction at most recent follow-up and requirement for repeat interventions (P < .01). Most have reduction of LV dimensions in the immediate postoperative period to normal limits.

CONCLUSION: In children with AR, preoperative LV dysfunction and extreme LV dilation (>4 SD) are significant predictors of incomplete LV remodeling or persistent LV dysfunction.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
22931553
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"