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Neoaortic bicuspid valve in arterial switch operation: mid-term follow-up
Shahid M Khan1, Ahmad Bin Sallehuddin, Ziad R Al-Bulbul
1King Faisal Heart Institute, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
The Annals of Thoracic Surgery
|December 25, 2007
Summary
Bicuspid pulmonary valves are common in patients undergoing arterial switch operations for transposition of the great arteries. These valves maintain functional integrity in the neoaortic position long-term.
Area of Science:
- Congenital Heart Surgery
- Pediatric Cardiology
- Cardiac Valve Morphology
Background:
- Transposition of the great arteries (TGA) is a complex congenital heart defect.
- The arterial switch operation (ASO) is a standard surgical repair for TGA.
- Pulmonary valve morphology in TGA patients is an important consideration for ASO outcomes.
Purpose of the Study:
- To determine the prevalence of bicuspid pulmonary valves in TGA patients undergoing ASO.
- To evaluate the long-term functional integrity of bicuspid pulmonary valves in the neoaortic position after ASO.
Main Methods:
- Retrospective review of 342 patients who underwent ASO for TGA between 1985 and 2001.
- Serial echocardiographic assessment of neoaortic valve function (regurgitation, gradients, diameter).
- Focus on patients identified with a bicuspid pulmonary valve.
Main Results:
- A bicuspid pulmonary valve was identified in 7% (24/342) of patients.
- Mean follow-up was 5.3 years for 22 patients with bicuspid pulmonary valves.
- No significant neoaortic stenosis developed; mild to trivial regurgitation was common, with severe regurgitation in 2 patients.
Conclusions:
- Bicuspid pulmonary valves are not rare in TGA patients undergoing ASO.
- Bicuspid pulmonary valves demonstrate durable function in the neoaortic position.
- The presence of a bicuspid pulmonary valve should not preclude an arterial switch operation.
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