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August 14, 2023The Korean Journal of Thoracic and Cardiovascular SurgeryOpen Access

Valve-Sparing Neo-Aortic Root Replacement for Neo-Aortic Root Dilatation 20 Years after Arterial Switch Operation for Transposition of the Great Arteries: A Case Report

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Key result

Valve-sparing neo-aortic root replacement successfully reduced the sizes of the aortic sinus and annulus, with only mild aortic regurgitation remaining at 12 months post-surgery.

Why the study?

Does valve-sparing neo-aortic root replacement improve aortic root dilatation and regurgitation in a patient with prior arterial switch operation?

Population

One 25-year-old man with neo-aortic root dilatation after arterial switch operation for TGA and VSD

Comparison

Valve-sparing neo-aortic root replacement with aortic valve repair

Design

Case report

Authors

SLSangjun LeeCKChan Hyeong KimJLJae Hong Lee

Discussion

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Overview

Should not yet change practice for late neo-aortic dilatation after ASO; leaves open durability of valve-sparing repair.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

Does valve-sparing neo-aortic root replacement improve aortic root dilatation and regurgitation in a patient with prior arterial switch operation?

P
Population
A 25-year-old man with neo-aortic root dilatation 20 years after an arterial switch operation for transposition of the great arteries, followed for 12 months post-surgery.
I
Intervention
Valve-sparing neo-aortic root replacement (David operation) with aortic valve repair using a 28-mm Gelweave Valsalva graft, along with left pulmonary artery angioplasty and right pulmonary artery repair.
O
Outcome
Reduction in the sizes of the aortic sinus and annulus, and degree of aortic regurgitation on postoperative echocardiographysurrogate

Valve-sparing neo-aortic root replacement (David operation) can be successfully performed for neo-aortic root dilatation in adult survivors of the arterial switch operation.

Limitations

  • Short-term follow-up of 1 year
  • Need for close observation for progression of aortic annulus dilatation and worsening aortic valve regurgitation
  • Short-term follow-up (1 year)
  • Uncertain long-term durability of the repaired native valve

Cite This Study

Lee et al. (2023) conducted a case report in Neo-aortic root dilatation after arterial switch operation (n=1). Valve-sparing neo-aortic root replacement (David operation) was evaluated on Postoperative aortic sinus and annulus size and degree of aortic regurgitation. Valve-sparing neo-aortic root replacement successfully reduced the sizes of the aortic sinus and annulus, with only mild aortic regurgitation remaining at 12 months post-surgery.

synapsesocial.com/papers/6a809755527a4b4caa31d464https://doi.org/10.5090/jcs.23.051
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Also Consider

Synapse has enriched 2 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Outcomes of 829 neonates with complete transposition of the great arteries 12–17 years after repair2003 · 187 citations
  2. 2Reoperation for neoaortic root pathology after the arterial switch operation2014 · 49 citations