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Common atrioventricular valve surgery in children with functional single ventricle
Benedikt Mayr1,2, Melchior Burri1,2, Martina Strbad2,3,4
1Department of Cardiovascular Surgery, German Heart Center Munich at the Technical University of Munich, Munich, Germany.
Summary
Common atrioventricular valve (CAVV) surgery in patients with functional single ventricle (FSV) has high mortality and reoperation rates. Outcomes for CAVV repair in univentricular physiology remain challenging.
Area of Science:
- Cardiology
- Pediatric Surgery
- Congenital Heart Disease
Background:
- Common atrioventricular valve (CAVV) is a risk factor for mortality in functional single ventricle (FSV) patients.
- CAVV surgery in FSV patients presents unique challenges with limited outcome data.
Purpose of the Study:
- To evaluate the outcomes of CAVV surgery in patients with functional single ventricle (FSV).
- To assess survival and reoperation rates following CAVV repair or replacement in univentricular physiology.
Main Methods:
- Retrospective review of CAVV surgical procedures in 66 children with FSV undergoing univentricular palliation.
- Analysis of survival and cumulative incidence of reoperation post-CAVV surgery.
Main Results:
- 30 patients (45.5%) required CAVV surgery, primarily for moderate (40%) or severe (60%) regurgitation.
- Operative and late mortality were 23.3% and 8.7%, respectively. 4-year survival was 68.9% post-surgery.
- 4-year reoperation incidence was 35.8%; 4-year survival was lower in patients with CAVV surgery compared to those without (69.7% vs 83%).
Conclusions:
- CAVV surgery in FSV patients is linked to significant mortality and a high rate of reoperation.
- Further research is needed to improve surgical outcomes for CAVV in univentricular hearts.
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