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Related Experiment Videos

Small aortic root in childhood: surgical options

D B Ross1, G A Trusler, J G Coles

  • 1Division of Cardiac Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.

The Annals of Thoracic Surgery
|December 1, 1994
PubMed
Summary

Pediatric aortic valve replacement often requires annular enlargement. Anterior annular enlargement showed higher early mortality but similar long-term survival compared to posterior techniques in this study.

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Area of Science:

  • Pediatric Cardiac Surgery
  • Congenital Heart Disease
  • Valvular Heart Disease

Background:

  • Pediatric aortic valve replacement (AVR) is challenging due to complex left ventricular outflow tract (LVOT) obstruction.
  • Annular enlargement techniques are frequently necessary for successful AVR in children.

Purpose of the Study:

  • To evaluate the outcomes of two distinct annular enlargement techniques in pediatric patients undergoing AVR.
  • To compare survival rates and identify factors influencing outcomes in this cohort.

Main Methods:

  • Retrospective review of 32 children undergoing AVR with annular enlargement between 1977 and 1991.
  • Two primary techniques: posterior patch annuloplasty (n=11) and anterior annular enlargement (aortoventriculoplasty, n=22).
  • Analysis of early mortality, late mortality, and actuarial survival based on technique and age.

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Main Results:

  • Posterior annuloplasty had one early and one late death. Anterior annuloplasty had a 22% hospital mortality rate.
  • Actuarial survival was 78% at 5 years and 65% at 10 years post-repair.
  • Infants under 1 year had significantly worse 5-year survival (33%) compared to older children (88%).

Conclusions:

  • Both posterior and anterior annular enlargement techniques can be employed for pediatric AVR.
  • Younger children, particularly infants, face higher mortality risks.
  • Survivors demonstrated good outcomes without reoperations due to somatic growth.