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Long-term outcomes of primary aortic valve repair in children with congenital aortic stenosis – 15-year experience at a single center

BACKGROUND: Studies on the long-term outcomes of children with congenital aortic stenosis who underwent primary aortic repair are limited. We reviewed the long-term outcomes of children who underwent aortic valve (AoV) repair at our center. METHODS: All children (n = 75) who underwent AoV repair bet...

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Autores principales: Ren, Qiushi, Yu, Juemin, Chen, Tianyu, Qiu, Hailong, Ji, Erchao, Liu, Tao, Xu, Xiaowei, Cen, Jianzheng, Wen, Shusheng, Zhuang, Jian, Liu, Xiaobing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9613358/
https://www.ncbi.nlm.nih.gov/pubmed/36312277
http://dx.doi.org/10.3389/fcvm.2022.1029245
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author Ren, Qiushi
Yu, Juemin
Chen, Tianyu
Qiu, Hailong
Ji, Erchao
Liu, Tao
Xu, Xiaowei
Cen, Jianzheng
Wen, Shusheng
Zhuang, Jian
Liu, Xiaobing
author_facet Ren, Qiushi
Yu, Juemin
Chen, Tianyu
Qiu, Hailong
Ji, Erchao
Liu, Tao
Xu, Xiaowei
Cen, Jianzheng
Wen, Shusheng
Zhuang, Jian
Liu, Xiaobing
author_sort Ren, Qiushi
collection PubMed
description BACKGROUND: Studies on the long-term outcomes of children with congenital aortic stenosis who underwent primary aortic repair are limited. We reviewed the long-term outcomes of children who underwent aortic valve (AoV) repair at our center. METHODS: All children (n = 75) who underwent AoV repair between 2006 and 2020 were reviewed. The Kaplan-Meier curve was used to demonstrate the survival estimates. The Cox proportional hazard model and competing risk regression model were used to identify risk factors for death, reintervention, adverse events, and replacement. RESULTS: The median age at surgery was 1.8 (IQR, 0.2–7.7) years, and the median weight at surgery was 10.0 (IQR, 5.0–24.0) kg. Early mortality and late mortality were 5.3% (4/75) and 5.6% (4/71), respectively. Risk factors for overall mortality were concomitant mitral stenosis (P = 0.01, HR: 9.8, 95% CI: 1.8–53.9), low AoV annulus Z-score (P = 0.01, HR: 0.6, 95% CI: 0.4–0.9), and prolonged cardiopulmonary bypass time (P < 0.01, HR: 9.5, 95% CI: 1.7–52.1). Freedom from reintervention was 72.9 ± 0.10% (95% CI: 56.3–94.4%) at 10 years. Risk factors for occurrence of adverse event on multivariable analysis included preoperative intubation (P = 0.016, HR: 1.004, 95% CI: 1.001–1.007) and a low AoV annulus Z-score (P = 0.019, HR: 0.714, 95% CI: 0.540–0.945). Tricuspid AoV morphology was associated with a suboptimal postoperative outcome (P = 0.03). CONCLUSION: Aortic valve repair remains a safe and durable solution for children with congenital aortic stenosis. Concomitant mitral stenosis and aortic valve anatomy, including tricuspid valve morphology and smaller annulus size, are associated with poor early and long-term outcomes.
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spelling pubmed-96133582022-10-28 Long-term outcomes of primary aortic valve repair in children with congenital aortic stenosis – 15-year experience at a single center Ren, Qiushi Yu, Juemin Chen, Tianyu Qiu, Hailong Ji, Erchao Liu, Tao Xu, Xiaowei Cen, Jianzheng Wen, Shusheng Zhuang, Jian Liu, Xiaobing Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: Studies on the long-term outcomes of children with congenital aortic stenosis who underwent primary aortic repair are limited. We reviewed the long-term outcomes of children who underwent aortic valve (AoV) repair at our center. METHODS: All children (n = 75) who underwent AoV repair between 2006 and 2020 were reviewed. The Kaplan-Meier curve was used to demonstrate the survival estimates. The Cox proportional hazard model and competing risk regression model were used to identify risk factors for death, reintervention, adverse events, and replacement. RESULTS: The median age at surgery was 1.8 (IQR, 0.2–7.7) years, and the median weight at surgery was 10.0 (IQR, 5.0–24.0) kg. Early mortality and late mortality were 5.3% (4/75) and 5.6% (4/71), respectively. Risk factors for overall mortality were concomitant mitral stenosis (P = 0.01, HR: 9.8, 95% CI: 1.8–53.9), low AoV annulus Z-score (P = 0.01, HR: 0.6, 95% CI: 0.4–0.9), and prolonged cardiopulmonary bypass time (P < 0.01, HR: 9.5, 95% CI: 1.7–52.1). Freedom from reintervention was 72.9 ± 0.10% (95% CI: 56.3–94.4%) at 10 years. Risk factors for occurrence of adverse event on multivariable analysis included preoperative intubation (P = 0.016, HR: 1.004, 95% CI: 1.001–1.007) and a low AoV annulus Z-score (P = 0.019, HR: 0.714, 95% CI: 0.540–0.945). Tricuspid AoV morphology was associated with a suboptimal postoperative outcome (P = 0.03). CONCLUSION: Aortic valve repair remains a safe and durable solution for children with congenital aortic stenosis. Concomitant mitral stenosis and aortic valve anatomy, including tricuspid valve morphology and smaller annulus size, are associated with poor early and long-term outcomes. Frontiers Media S.A. 2022-10-13 /pmc/articles/PMC9613358/ /pubmed/36312277 http://dx.doi.org/10.3389/fcvm.2022.1029245 Text en Copyright © 2022 Ren, Yu, Chen, Qiu, Ji, Liu, Xu, Cen, Wen, Zhuang and Liu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Ren, Qiushi
Yu, Juemin
Chen, Tianyu
Qiu, Hailong
Ji, Erchao
Liu, Tao
Xu, Xiaowei
Cen, Jianzheng
Wen, Shusheng
Zhuang, Jian
Liu, Xiaobing
Long-term outcomes of primary aortic valve repair in children with congenital aortic stenosis – 15-year experience at a single center
title Long-term outcomes of primary aortic valve repair in children with congenital aortic stenosis – 15-year experience at a single center
title_full Long-term outcomes of primary aortic valve repair in children with congenital aortic stenosis – 15-year experience at a single center
title_fullStr Long-term outcomes of primary aortic valve repair in children with congenital aortic stenosis – 15-year experience at a single center
title_full_unstemmed Long-term outcomes of primary aortic valve repair in children with congenital aortic stenosis – 15-year experience at a single center
title_short Long-term outcomes of primary aortic valve repair in children with congenital aortic stenosis – 15-year experience at a single center
title_sort long-term outcomes of primary aortic valve repair in children with congenital aortic stenosis – 15-year experience at a single center
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9613358/
https://www.ncbi.nlm.nih.gov/pubmed/36312277
http://dx.doi.org/10.3389/fcvm.2022.1029245
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