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Correlation of anatomic and hemodynamic features with aortic valve leaflet deformity in doubly committed subarterial

J Kobayashi1, K Koike, H Senzaki

  • 1Department of Pediatric Cardiology, Saitama Heart Institute, Saitama Medical School, Iruma-gun, Japan.

Heart and Vessels
|June 1, 2000
PubMed

Insights

Doubly committed subarterial ventricular septal defect (DCVSD) repair can lead to aortic valve leaflet deformity and aortic regurgitation (AR), especially with arterial valve offsetting and increasing age. Pulmonary hypertension may offer protection against leaflet prolapse.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Doubly committed subarterial ventricular septal defect (DCVSD) is a complex congenital heart defect.
  • Aortic valve leaflet deformity and subsequent aortic regurgitation (AR) are known complications following surgical repair.

Purpose of the Study:

  • To investigate factors contributing to aortic valve leaflet deformity in patients with DCVSD undergoing intracardiac repair.
  • To identify predictors of aortic regurgitation (AR) in this patient population.

Main Methods:

  • Retrospective analysis of 153 patients with DCVSD who underwent intracardiac repair.
  • Classification of patients based on the presence or absence of arterial valve offsetting.
  • Evaluation of echocardiographic, angiographic, and intraoperative findings.

Main Results:

  • Arterial valve offsetting was present in 88.9% of patients and significantly correlated with leaflet deformity (46.3% vs 5.9%) and AR (50.0% vs 2.2%).
  • Pulmonary hypertension (higher pulmonary-to-systemic pressure ratio) was associated with less leaflet deformity in patients with offsetting.
  • Increasing age was linked to increased severity of leaflet deformity and AR.

Conclusions:

  • Arterial valve offsetting, increasing age, and the absence of pulmonary hypertension are key factors contributing to aortic valve leaflet deformity and AR in DCVSD.
  • Anatomic and hemodynamic features of DCVSD significantly influence the development of these complications.

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