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Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure
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Reexamining remodelling in children.

Shunsuke Matsushima1, Alexander Heß1, Julia Renata Lämmerzahl1

  • 1Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|January 24, 2020
PubMed
Summary
This summary is machine-generated.

Aortic root remodelling is a viable valve-sparing procedure in children when combined with cusp repair and annuloplasty. This technique offers favorable outcomes for pediatric patients requiring aortic root replacement.

Keywords:
ChildrenCongenital heart diseaseConnective tissue diseasePaediatric patientRoot remodellingValve-sparing aortic root replacement

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Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Thoracic Surgery

Background:

  • Valve-sparing aortic root replacement in children is debated due to concerns about valve failure.
  • Root remodelling has been questioned as a suitable technique for pediatric aortic root replacement.

Purpose of the Study:

  • To review the experience with root remodelling in pediatric patients undergoing valve-sparing aortic root replacement.
  • To evaluate the efficacy and safety of root remodelling in children.

Main Methods:

  • Retrospective review of 17 pediatric patients (age ≤18 years) who underwent root remodelling between 1999 and 2016.
  • Intraoperative cusp effective height measurement and central plication for prolapse correction were introduced in 2004.
  • Suture annuloplasty for annular dilatation was implemented after 2009.

Main Results:

  • 17 consecutive pediatric patients with a median age of 14 years underwent the procedure.
  • Aortic valve morphology varied, with 10 tricuspid, 5 bicuspid, and 1 unicuspid.
  • Follow-up averaged 6.5 years, with 14 patients maintaining mild or less aortic regurgitation. One patient required reoperation for cusp prolapse.

Conclusions:

  • Root remodelling, when combined with appropriate cusp repair and annuloplasty, can yield favorable results in children.
  • This valve-sparing technique is a suitable option for pediatric aortic root replacement.