Valve-sparing aortic root replacement in children: Outcomes from 100 consecutive cases

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Aortic Disease

Background:

• Aortic root aneurysms in children often necessitate surgical intervention.
• Valve-sparing root replacement (VSRR) offers an alternative to traditional prostheses.
• Limited data exist on long-term outcomes of VSRR in pediatric populations.

Purpose of the Study:

• To evaluate the safety and efficacy of VSRR in pediatric patients.
• To compare outcomes between different VSRR techniques.
• To identify risk factors for complications and reinterventions.

Main Methods:

• Retrospective review of 100 consecutive pediatric VSRR procedures from 1997-2017.
• Analysis of echocardiographic and clinical data.
• Primary endpoint: mortality; Secondary endpoints: complications, reinterventions, valvular dysfunction.

Main Results:

• Median age was 13.6 years; common diagnoses included Marfan and Loeys-Dietz syndromes.
• Perioperative mortality was 2%. Late reinterventions were needed for pseudoaneurysms in 6% of patients.
• Reimplantation procedures showed significantly lower rates of late valve replacement compared to remodeling (5.9% vs. 33.3%).

Conclusions:

• VSRR is a safe and effective treatment for pediatric aortic root aneurysms.
• The reimplantation technique is associated with better long-term valve outcomes.
• Late aortic insufficiency and pseudoaneurysm formation are potential complications requiring vigilance.