Aortic Valve Repair for Congenital Abnormalities of the Aortic Valve

Quader, Mohammed A.; Rosenthal, Geoffrey L.; Qureshi, Athar M.; Mee, Roger B.B.; Mumtaz, Muhammed A.; Joshi, Raja; Duncan, Brian W.

doi:10.1016/j.hlc.2006.05.005

« Previous Next »Heart, Lung and Circulation
Volume 15, Issue 4 , Pages 248-255, August 2006

Aortic Valve Repair for Congenital Abnormalities of the Aortic Valve☆

Mohammed A. Quader, MD
- Department of Pediatric and Congenital Heart Surgery/M41, Children's Hospital, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States
Geoffrey L. Rosenthal, MD, PhD
- Department of Pediatric Cardiology, Children's Hospital, Cleveland Clinic, Cleveland, OH 44195, United States
Athar M. Qureshi, MD
- Department of Pediatric Cardiology, Children's Hospital, Cleveland Clinic, Cleveland, OH 44195, United States
Roger B.B. Mee, MD
- Department of Pediatric and Congenital Heart Surgery/M41, Children's Hospital, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States
Muhammed A. Mumtaz, MD
- Department of Pediatric and Congenital Heart Surgery/M41, Children's Hospital, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States
Raja Joshi, MD
- Department of Pediatric and Congenital Heart Surgery/M41, Children's Hospital, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States
Brian W. Duncan, MD
- Department of Pediatric and Congenital Heart Surgery/M41, Children's Hospital, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States
- Corresponding author. Tel.: +1 216 444 9365; fax: +1 216 445 3692.

Received 30 July 2004; received in revised form 22 February 2006; accepted 8 May 2006.

Background

Due to shortcomings of any valve replacement, repairing and retaining the native valve may be beneficial for congenital aortic valve disease.

Methods

Retrospective review of data and follow-up of aortic valve repair from a single institution.

Results

From 1993 to 2001, 56 patients underwent aortic valve repair [median age 13.4 years (range 1 day to 45 years)]. The predominant aortic valve lesion was mixed aortic stenosis/aortic insufficiency 25 (45%), aortic insufficiency 24 (43%) and aortic stenosis 7 (13%). Repair techniques included sub-commissural plication 36 (64%), commissurotomy 24 (43%), cusp plication 15 (27%), pericardial patch cusp extension 8 (14%) and resuspension of commissures 4 (7%). Most patients (88%) required a combination of techniques; 61% required additional procedures. Hospital survival was 55/56 [98%; (95% CI 91–100%)] no patient was discharged on anticoagulation for aortic valve pathology. Fifty-three patients [95%; (95% CI 85–98%)] remain alive after a median follow-up of 37 months; four survivors required aortic valve replacement and two required repeat aortic valve repair [84%; (95% CI 72–91%) reintervention-free survival].

Conclusions

(1) In this study, aortic valve repair for congenital abnormalities avoided reoperation in the majority of patients, avoided anticoagulation and retained growth potential of the valve. (2) Repeat aortic valve repair or replacement was used to treat subsequent valve deterioration.

Keywords: Aortic valve, Valve disease, Ross operation, Pediatric, CHD valve lesions