Single Aortic Cusp Replacement with Bovine Pericardium for Children with Ventricular Septal Defect and Aortic Regurgitation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

JINJing , HUAZheng-dong , ZENGXiang-jun , ZHOUHong , ZHOUDan ,  TAOLiang

Department of Cardiac Surgery, Wuhan Asia Heart Hospital, Wuhan 430022, P. R. China;

Corresponding author：

TAOLiang, Email: taoliangmd@gmail.com

Keywords：

Ventricular septal defect; Aortic regurgitation; Bovine pericardium; Aortic valvuloplasty

DOI：

10.7507/1007-4848.20140063

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Objective To assess clinical results of single aortic cusp replacement with bovine pericardium for children with ventricular septal defect (VSD) and severe aortic regurgitation (AR). Methods Clinical data of 42 children with VSD and severe AR who underwent single aortic cusp replacement with bovine pericardium in Wuhan Asia Heart Hospital from March 2006 to September 2009 were retrospectively analyzed. There were 28 male and 14 female patients with their age of 2-14 (9.0±3.6) years. All the patients were in NYHA class Ⅱ. Results No early mortality or major morbidity was recorded. Intraoperative transesophageal echocardiography showed successful repair with normal coaptation of the aortic leaflets in all the patients. AR grade was less than mild in all the patients with peak aortic valve pressure gradients of 14.2±2.8 mm Hg. All the patients were discharged from the hospital within 11 postoperative days without any adverse symptom,and were followed up for 32-72 (50±16) months. During follow-up,all the patients were in NYHA class I. There were 17 patients without AR,21 patients with mild AR and 4 patients with moderate AR. The peak aortic valve pressure gradient was 12.4±3.2 mm Hg. None of the patients died or required reoperation,and structural valve degeneration was not observed during follow-up. Conclusion Single aortic cusp replacement with bovine pericardium can produce good hemodynamics and midterm results for children with VSD and severe AR.

Citation： JINJing, HUAZheng-dong, ZENGXiang-jun, ZHOUHong, ZHOUDan, TAOLiang. Single Aortic Cusp Replacement with Bovine Pericardium for Children with Ventricular Septal Defect and Aortic Regurgitation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(2): 216-219. doi: 10.7507/1007-4848.20140063 Copy

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2.	Cheung YF,Chiu CS,Yung TC,et al.Impact of preoperative aortic cusp prolapse on long-term outcome after surgical closure of subarterial ventricular septal defect.Ann Thorac Surg,2002,73 (2):622-627.
3.	Brauner R,Birk E,Sahar G,et al.Surgical management of ventricular septal defect with aortic valve prolapse:clinical considerations and results.Eur J Cardiothorac Surg,1995,9 (6):315-319.
4.	Fiane AE,Lindberg HL,Saatvedt K,et al.Mechanical valve replacement in congenital heart disease.J Heart Valve Dis,1996,5 (3):337-342.
5.	Elgamal MA,Hakimi M,Lyons JM,et al.Risk factors for failure of aortic valvuloplasty in aortic insufficiency with ventricular septal defect.Ann Thorac Surg,1999,68 (4):1350-1355.
6.	Tao L,Zeng XJ,Lim YP.Single cusp replacement for aortic regurgitation.Ann Thorac Surg,2008,85 (3):946-948.
7.	Tohyama K,Satomi G,Momma K.Aortic valve prolapse and aortic regurgitation associated with subpulmonic ventricular septal defect.Am J Cardiol,1997,79 (9):1285-1289.
8.	Santini F,Mazzucco A.Timing for surgical closure of subpulmonary ventricular septal defects in infancy.Am J Cardiol,1997,80 (7):976-977.
9.	Rathore KS.Aortic regurgitation with ventricular septal defect in the young.Asian Cardiovasc Thorac Ann,2006,14 (2):93-97.
10.	Kvidal P,Bergström R,Malm T,et al.Long-term follow-up of morbidity and mortality after aortic valve replacement with a mechanical valve prosthesis.Eur Heart J,2000,21 (13):1099-1111.
11.	Lupinetti FM,Duncan BW,Lewin M,et al.Comparison of autograft and allograft aortic valve replacement in children.J Thorac Cardiovasc Surg,2003,126 (1):240-246.
12.	Tomita H,Arakaki Y,Ono Y,et al.Evolution of aortic regurgitation following simple patch closure of doubly committed subarterial ventricular septal defect.Am J Cardiol,2000,86 (5):540-542.
13.	Laudito A,Brook MM,Suleman S,et al.The Ross procedure in children and young adults:a Word of caution.J Thorac Cardiovasc Surg,2001,122 (1):147-153.
14.	de Sa M,Moshkovitz Y,Butany J,et al.Histologic abnormalities of the ascending aorta and pulmonary trunk in patients with bicuspid aortic valve disease:clinical relevance to the ross procedure.J Thorac Cardiovasc Surg,1999,118 (4):588-594.
15.	Halees ZA,Shahid MA,Duran C,et al.Up to 16 years follow-up of aortic valve Reconstruction with pericardium:a stentless readily available cheap valve? Eur J Cardio-thoracic Surg,2005,28 (2):200-205.

1. Yacoub MH,Khan H,Stavri G,et al.Anatomic correction of the syndrome of prolapsing right coronary aortic cusp,dilatation of the sinus of Valsalva,and ventricular septal defect.J Thorac Cardiovasc Surg,1997,113 (2):253-260.
2. Cheung YF,Chiu CS,Yung TC,et al.Impact of preoperative aortic cusp prolapse on long-term outcome after surgical closure of subarterial ventricular septal defect.Ann Thorac Surg,2002,73 (2):622-627.
3. Brauner R,Birk E,Sahar G,et al.Surgical management of ventricular septal defect with aortic valve prolapse:clinical considerations and results.Eur J Cardiothorac Surg,1995,9 (6):315-319.
4. Fiane AE,Lindberg HL,Saatvedt K,et al.Mechanical valve replacement in congenital heart disease.J Heart Valve Dis,1996,5 (3):337-342.
5. Elgamal MA,Hakimi M,Lyons JM,et al.Risk factors for failure of aortic valvuloplasty in aortic insufficiency with ventricular septal defect.Ann Thorac Surg,1999,68 (4):1350-1355.
6. Tao L,Zeng XJ,Lim YP.Single cusp replacement for aortic regurgitation.Ann Thorac Surg,2008,85 (3):946-948.
7. Tohyama K,Satomi G,Momma K.Aortic valve prolapse and aortic regurgitation associated with subpulmonic ventricular septal defect.Am J Cardiol,1997,79 (9):1285-1289.
8. Santini F,Mazzucco A.Timing for surgical closure of subpulmonary ventricular septal defects in infancy.Am J Cardiol,1997,80 (7):976-977.
9. Rathore KS.Aortic regurgitation with ventricular septal defect in the young.Asian Cardiovasc Thorac Ann,2006,14 (2):93-97.
10. Kvidal P,Bergström R,Malm T,et al.Long-term follow-up of morbidity and mortality after aortic valve replacement with a mechanical valve prosthesis.Eur Heart J,2000,21 (13):1099-1111.
11. Lupinetti FM,Duncan BW,Lewin M,et al.Comparison of autograft and allograft aortic valve replacement in children.J Thorac Cardiovasc Surg,2003,126 (1):240-246.
12. Tomita H,Arakaki Y,Ono Y,et al.Evolution of aortic regurgitation following simple patch closure of doubly committed subarterial ventricular septal defect.Am J Cardiol,2000,86 (5):540-542.
13. Laudito A,Brook MM,Suleman S,et al.The Ross procedure in children and young adults:a Word of caution.J Thorac Cardiovasc Surg,2001,122 (1):147-153.
14. de Sa M,Moshkovitz Y,Butany J,et al.Histologic abnormalities of the ascending aorta and pulmonary trunk in patients with bicuspid aortic valve disease:clinical relevance to the ross procedure.J Thorac Cardiovasc Surg,1999,118 (4):588-594.
15. Halees ZA,Shahid MA,Duran C,et al.Up to 16 years follow-up of aortic valve Reconstruction with pericardium:a stentless readily available cheap valve? Eur J Cardio-thoracic Surg,2005,28 (2):200-205.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Single Aortic Cusp Replacement with Bovine Pericardium for Children with Ventricular Septal Defect and Aortic Regurgitation

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