ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Moninder S. Bhabra
Sunil Bhudia
Babulal Sethia
John G. C. Wright
David J. Barron
William J. Brawn
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bhabra, M. S.
Right arrow Articles by Brawn, W. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bhabra, M. S.
Right arrow Articles by Brawn, W. J.
Related Collections
Right arrow Congenital - acyanotic

Ann Thorac Surg 2003;76:1412-1416
© 2003 The Society of Thoracic Surgeons

Original article: cardiovascular

Surgical aortic valvotomy in infancy: impact of leaflet morphology on long-term outcomes

Moninder S. Bhabra, DMa, Rami Dhillon, MRCPb, Sunil Bhudia, FRCSa, Babulal Sethia, FRCSa,b, Paul Miller, MRCPb, Oliver Stumper, PhDb, John G. C. Wright, FRCPb, Joseph V. De Giovanni, FRCPb, David J. Barron, MDa, William J. Brawn, FRCSa*

a Department of Cardiac Surgery, Birmingham Childrens' Hospital, Birmingham, United Kingdom
b Department of Cardiology, Birmingham Childrens' Hospital, Birmingham, United Kingdom

Accepted for publication April 25, 2003.

* Address reprint requests to Dr Brawn, Department of Cardiac Surgery, Birmingham Childrens' Hospital, Steelhouse Lane, Birmingham B4 6NH, UK.
e-mail: elizabeth.leeson{at}bhamchildrens.wmids.nhs.uk

BACKGROUND: Surgical valvotomy for critical aortic stenosis in children enables relatively accurate commissurotomies to be fashioned, resulting in the formation of two or three leaflets. We hypothesized that outcomes after surgery may be best in patients in whom three leaflets are produced.

METHODS: A retrospective review of infants undergoing primary surgical valvotomy at our institution during a 12-year period was carried out. Patients who had additional intracardiac defects were excluded. Clinical and echocardiographic follow-up data were analyzed.

RESULTS: Fifty-four patients fulfilled the study criteria. Median age at surgery was 3 weeks (range, 0 to 51 weeks). Commissurotomy resulted in bileaflet anatomy in 41 patients (group A) and trileaflet anatomy in 13 patients (group B). Operative mortality was 5% in group A and 0% in group B (p = 1.0). In group A, 18 patients required one or more aortic valve reinterventions, including valve replacement in 8 patients. In group B, there was only one reintervention (repeat valvotomy). Kaplan-Meier analysis showed that at 10 years, comparisons of group A versus group B were as follows: actuarial survival, 85% versus 100% (p = 0.15); freedom from reintervention, 33% versus 92% (p = 0.01); freedom from aortic reoperation, 45% versus 92% (p = 0.04); and freedom from aortic valve replacement, 57% versus 100% (p = 0.07).

CONCLUSIONS: Long-term outcomes after aortic valvotomy are significantly better in infants in whom surgery results in trileaflet rather than bileaflet anatomy. Preoperative evaluation of valve morphology may enable selection of a group of patients in whom results of surgery are excellent.




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
P. Rehnstrom, T. Malm, P. Jogi, E. Fernlund, P. Winberg, J. Johansson, and S. Johansson
Outcome of Surgical Commissurotomy for Aortic Valve Stenosis in Early Infancy
Ann. Thorac. Surg., August 1, 2007; 84(2): 594 - 598.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
B. Alsoufi, T. Karamlou, B. W. McCrindle, and C. A. Caldarone
Management options in neonates and infants with critical left ventricular outflow tract obstruction
Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 1013 - 1021.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
G. Agnoletti, O. Raisky, Y. Boudjemline, P. Ou, D. Bonnet, D. Sidi, and P. Vouhe
Neonatal Surgical Aortic Commissurotomy: Predictors of Outcome and Long-Term Results
Ann. Thorac. Surg., November 1, 2006; 82(5): 1585 - 1592.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
T. Miyamoto, N. Sinzobahamvya, J. Wetter, R. Kallenberg, A. M. Brecher, B. Asfour, and A. E. Urban
Twenty years experience of surgical aortic valvotomy for critical aortic stenosis in early infancy.
Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 35 - 40.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2003 by The Society of Thoracic Surgeons.