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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Valve-sparing aortic root replacement for patients with a Fontan circulation.
Eldad Erez1, Vincent K H Tam, Carlos Galliani
1Cook Children's Medical Center, University of North Texas, Fort Worth, Texas 76104, USA. eerez@cookchildrens.org
The Journal of Heart Valve Disease
|June 1, 2012
Summary
Aortic root replacement is effective for single-ventricle patients with aortic dilatation. However, significant aortic insufficiency may necessitate future valve replacement, impacting long-term outcomes.
Area of Science:
- Cardiovascular Surgery
- Congenital Heart Disease
- Aortic Aneurysm
Background:
- Aortic root aneurysm is an emerging concern in hypoplastic left heart syndrome (HLHS) and single-ventricle physiology.
- Management strategies for these complex patients are evolving.
Purpose of the Study:
- To review the experience with valve-sparing aortic root replacement in patients with single-ventricle physiology.
- To assess the efficacy and long-term outcomes of this procedure.
Main Methods:
- Retrospective review of four patients (aged 11-19) with progressive aortic root dilatation.
- All patients had undergone Fontan completion for various single-ventricle conditions.
- Procedures included valve-sparing aortic root replacement, annular reduction, and ascending aorta replacement.
Main Results:
- At a mean follow-up of 2.6 years, all patients were in NYHA functional class I.
- Two patients with HLHS required neo-aortic valve replacement due to severe insufficiency.
- The remaining two patients had mild aortic insufficiency and good single-ventricle function.
Conclusions:
- Aortic root reimplantation is an effective treatment for aortic root dilatation in single-ventricle patients.
- Long-term freedom from valve replacement is uncertain in cases with significant aortic insufficiency.
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