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Common atrioventricular valve failure during single ventricle palliation†.
King, Gregory; Gentles, Thomas L; Winlaw, David S; Cordina, Rachel; Bullock, Andrew; Grigg, Leeanne E; Alphonso, Nelson; Radford, Dorothy J; Zannino, Diana; Buratto, Edward; d'Udekem, Yves.
Afiliación
  • King G; Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.
  • Gentles TL; Green Lane Paediatric and Congenital Cardiac Service, Starship Children's Hospital, Auckland, New Zealand.
  • Winlaw DS; Heart Centre for Children, The Children's Hospital at Westmead, Sydney, Australia.
  • Cordina R; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia.
  • Bullock A; Department of Cardiology, Princess Margaret Hospital for Children, Perth, Australia.
  • Grigg LE; Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia.
  • Alphonso N; Queensland Paediatric Cardiac Services, Lady Cilento Children's Hospital, Brisbane, Australia.
  • Radford DJ; Adult Congenital Heart Unit, The Prince Charles Hospital, Brisbane, Australia.
  • Zannino D; Heart Research, Murdoch Childrens Research Institute, Melbourne, Australia.
  • Buratto E; Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.
  • d'Udekem Y; Heart Research, Murdoch Childrens Research Institute, Melbourne, Australia.
Eur J Cardiothorac Surg ; 51(6): 1037-1043, 2017 Jun 01.
Article en En | MEDLINE | ID: mdl-28369323
OBJECTIVES: To determine the risk of atrioventricular valve failure (valve intervention or moderate or greater regurgitation) during the lifetime of patients with single ventricle physiology and common atrioventricular valve. METHODS: Patients' data were extracted from an existing bi-national, population based registry. A retrospective review of their medical records was undertaken to determine the incidence of atrioventricular valve repair/replacement or moderate or greater regurgitation. RESULTS: From a registry of 1468 Fontan survivors, 136 patients with common atrioventricular valve were identified. Complete echocardiographic follow-up was available for 114 patients. Median length of follow-up was 10.2 years (interquartile range 5-15 years). Twenty-five year survival and freedom from Fontan failure were 94% [95% confidence interval (CI), 88-100%] and 74% (95% CI, 64-87%), respectively. Twenty-eight patients underwent 24 initial repairs and 4 replacements. The 24 patients undergoing repair subsequently needed 6 re-repairs, 2 replacements and 8 had moderate or greater regurgitation at last follow-up. Four-year freedom from atrioventricular valve repair failure was 50% (95% CI, 34-75%). An additional 30 patients developed moderate or greater atrioventricular valve regurgitation (6 New York Heart Association ≥3, 10 Fontan failures, 0 deaths). Cumulative incidence of the composite endpoint of atrioventricular valve failure at 28 years was 62% (95% CI, 49-74%). CONCLUSIONS: Patients with single ventricle physiology and common atrioventricular valve experience a continuous decline in valve function. The majority of patients experience valve failure in the first 30 years of life.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimiento de Fontan / Defectos de los Tabiques Cardíacos / Ventrículos Cardíacos Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Alemania

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimiento de Fontan / Defectos de los Tabiques Cardíacos / Ventrículos Cardíacos Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Alemania