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Early experience with valve-sparing aortic root replacement in children.
Luca A Vricella1, Jason A Williams, William J Ravekes
1Division of Pediatric Cardiac Surgery, The Johns Hopkins University Hospital, Baltimore, Maryland, USA. lvricella@jhmi.edu
The Annals of Thoracic Surgery
|October 26, 2005
Summary
Aortic valve-sparing root replacement is a safe and effective option for children with ascending aorta aneurysms, offering durable results with minimal complications. Reimplantation techniques show superior long-term outcomes compared to remodeling.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Thoracic Surgery
Background:
- Aortic valve-sparing root replacement (AVSRR) is established in adults for ascending aorta aneurysms.
- Limited pediatric experience exists, despite AVSRR's advantages in avoiding valve prostheses in children.
Purpose of the Study:
- To evaluate the outcomes of AVSRR in pediatric patients.
- To compare different AVSRR techniques in children.
Main Methods:
- Retrospective clinical study of 19 pediatric patients undergoing AVSRR between 1997 and 2004.
- Data collected via chart review and outpatient follow-up, including echocardiography.
Main Results:
- No operative mortality; one reoperation for bleeding.
- 15.8% required late aortic valve replacement; most had no or mild insufficiency.
- Reimplantation procedures showed no reoperations or more than mild insufficiency.
Conclusions:
- AVSRR is a viable alternative to prosthetic root replacement in children.
- Reimplantation techniques offer more durable results than remodeling for pediatric aortic root enlargement.