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Outcomes of biventricular repair for shone's complex

Ahmed F Elmahrouk1,2, Mohamed F Ismail1,3, Amr A Arafat2

  • 1Division of Cardiac Surgery, Department of Cardiovascular, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.

Journal of Cardiac Surgery
|October 8, 2020
PubMed

Insights

Biventricular repair for Shone's complex shows good outcomes, with significant growth observed in the mitral valve (MV) and left ventricular outflow tract (LVOT) post-surgery. Reoperation is common, particularly with associated aortic valve issues.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Cardiac Surgery

Background:

  • Shone's complex is a rare congenital heart defect involving the mitral valve (MV) and left ventricular outflow tract (LVOT).
  • This condition necessitates complex surgical intervention for optimal outcomes.

Purpose of the Study:

  • To evaluate the outcomes of biventricular repair in patients with Shone's complex.
  • To assess the growth of the MV, aortic valve, and LVOT post-repair.
  • To determine long-term survival rates and identify factors influencing reoperation.

Main Methods:

  • Retrospective analysis of patients diagnosed with Shone's complex undergoing biventricular repair.
  • Collection of data on patient characteristics, MV lesions, and associated anomalies.
  • Regular echocardiographic follow-up to monitor MV, aortic valve, and LVOT z-scores.

Main Results:

  • Thirty-seven patients were included; 30.6% had pulmonary hypertension.
  • Coarctation repair was the most common initial procedure (70%).
  • Survival rates at 1, 5, and 10 years were 94.4%, 90%, and 76.9%, respectively. Reoperation was required in 13 patients, associated with aortic valve lesions. Significant growth was noted in MV (0.35/year) and LVOT (0.53/year) z-scores.

Conclusions:

  • Biventricular repair offers favorable outcomes for Shone's complex.
  • Reoperation is frequently necessary, especially in cases with low aortic valve z-scores.
  • Post-repair, the MV and LVOT demonstrate substantial growth, indicating successful surgical management.
Abstract

Keywords:
biventricular repaircoarctation of the aortacongenital aortic stenosisleft ventricular outflow tract obstructionparachute mitral valveshone's complex

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