Related Experiment Video

Updated: May 19, 2026

Studying Left Ventricular Reverse Remodeling by Aortic Debanding in Rodents
07:26

Studying Left Ventricular Reverse Remodeling by Aortic Debanding in Rodents

Published on: July 14, 2021

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

Sujatha Buddhe1, Wei Du, Henry L Walters

  • 1Section of Pediatric Cardiology and Cardiovascular Surgery, Carmen and Ann Adams Department of Pediatrics, The Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Mich, USA. drbuddhe@gmail.com

Congenital Heart Disease
|August 31, 2012
PubMed

Insights

In pediatric patients with isolated aortic regurgitation (AR), preoperative left ventricular (LV) dysfunction and extreme LV dilation predict poor postoperative outcomes. Early intervention is key for successful LV remodeling after aortic valve replacement.

Area of Science:

  • Pediatric Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • Controversy exists regarding optimal surgical timing for asymptomatic or minimally symptomatic isolated aortic regurgitation (AR).
  • Limited pediatric studies focus on isolated AR, with most addressing combined aortic valve stenosis and regurgitation.

Purpose of the Study:

  • To identify preoperative risk factors predicting postoperative outcomes in pediatric patients undergoing aortic valve replacement for isolated AR.
  • To assess predictors of persistent left ventricular (LV) dilation and dysfunction post-surgery.

Main Methods:

  • Retrospective analysis of 53 pediatric patients with biventricular physiology and morphologic LV undergoing aortic valve surgery for AR (1988-2010).
  • Collection of demographic, clinical, and echocardiographic data preoperatively, early postoperatively, at 1 year, and at most recent follow-up.
  • Comparison of outcomes between patients with LV end-diastolic diameter (LVEDD) z-score >4 SD and <4 SD.

Main Results:

  • Preoperative LVEDD z-score >4 SD predicted persistent LV dilation post-surgery.
  • Preoperative decreased LV function (fractional shortening <28%) was a significant predictor of persistent LV dysfunction and need for repeat interventions.
  • Most patients experienced reduction of LV dimensions to normal limits postoperatively.

Conclusions:

  • Preoperative LV dysfunction and extreme LV dilation (>4 SD) are significant predictors of incomplete LV remodeling or persistent LV dysfunction in pediatric patients with AR.
  • These findings aid in surgical timing and risk stratification for pediatric aortic regurgitation.
Abstract

More Related Videos

Surgically Induced Cardiac Volume Overload by Aortic Regurgitation in Mouse08:12

Surgically Induced Cardiac Volume Overload by Aortic Regurgitation in Mouse

Published on: August 30, 2022

Rat Model of Right-Sided Cardiac Remodeling and Arrhythmia Using Pulmonary Artery Banding10:39

Rat Model of Right-Sided Cardiac Remodeling and Arrhythmia Using Pulmonary Artery Banding

Published on: August 30, 2024

Related Concept Videos

Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
Aortic Regurgitation IV: Nursing Management01:17

Aortic Regurgitation IV: Nursing Management

A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...