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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Aortic Valve Intervention During Aortic Root Surgery in Children: A Systematic Review

Maria Rodriguez1,2, Anahita Malvea2, Dayre McNally3

  • 1Division of Cardiovascular Surgery, 27338Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

World Journal for Pediatric & Congenital Heart Surgery
|August 28, 2020
PubMed

Insights

Surgical management of pediatric aortic root dilatation is challenging. Valve-sparing aortic root surgery shows excellent survival up to one year, but long-term mortality and reintervention rates increase.

Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Thoracic Surgery

Background:

  • Pediatric aortic root dilatation is a critical condition lacking surgical management guidelines.
  • Aortic valve interventions during aortic root surgery require further analysis for improved decision-making.

Purpose of the Study:

  • To analyze data on aortic valve interventions during pediatric aortic root surgery.
  • To guide surgical decision-making for this life-threatening condition.

Main Methods:

  • Comprehensive literature search across multiple databases (MEDLINE, Embase, CENTRAL, etc.).
  • Inclusion of randomized controlled trials, cohorts, and case series from 1999-2019.
  • Focus on pediatric patients (0-18 years) undergoing valve-sparing or valve-replacing aortic root surgery.

Main Results:

  • Five observational studies involving 81 pediatric patients were identified.
  • Valve-sparing procedures included reimplantation (74%) and remodeling (26%).
  • No mortality reported up to one year; long-term mortality rate was 0.02/patient-year and reintervention rate was 0.08/patient-year.

Conclusions:

  • Limited data exists on aortic valve intervention during pediatric aortic root surgery.
  • Valve-sparing aortic root surgery demonstrates excellent short-term survival, with increased long-term mortality and reintervention rates.
  • Small sample sizes and lack of controlled studies hinder direct comparison of surgical techniques.
Abstract

Keywords:
aneurysmaortic operationaortic rootaortic valve repairaortic valve replacementpediatricreoperation

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