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November 1, 1998HeartOpen Access

Maintaining tricuspid valve competence in double discordance: a challenge for the paediatric cardiologist

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Key result

Anatomical correction restoring a systemic left ventricle improved tricuspid regurgitation with 11% mortality, whereas conventional surgery leaving the right ventricle in systemic position had 33% mortality.

Why the study?

How do different surgical interventions affect tricuspid valve function in children with double discordance and an abnormal tricuspid valve?

Population

141 consecutive patients admitted in the first year of life with various types of double discordance…

Design

Cohort

Authors

PAPhilippe AcarDSDaniel SidiDBDamien Bonnet

Discussion

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Overview

May support anatomical correction in double discordance; hypothesis-generating and should not yet change practice without randomized confirmation.

Study Design

Type

Cohort (n=62)

Structured PICO

How do different surgical interventions affect tricuspid valve function in children with double discordance and an abnormal tricuspid valve?

P
Population
62 infants admitted in the first year of life with double discordance and an abnormal tricuspid valve, followed through palliative and open heart procedures.
E
Exposure
Various surgical interventions including palliative procedures (pulmonary artery banding, aortopulmonary shunt), conventional surgery, and anatomical correction.
O
Outcome
Tricuspid valve function (grading of tricuspid regurgitation) and mortality.surrogate

In patients with double discordance and an abnormal tricuspid valve, interventions that decrease right ventricular volume or increase left ventricular pressure (such as anatomical correction) improve tricuspid valve function, whereas conventional surgery leaving the right ventricle in the systemic position leads to failure of tricuspid valve repair.

Cite This Study

Acar et al. (1998) conducted a cohort in Double discordance (congenitally corrected transposition of the great arteries) with abnormal tricuspid valve (n=62). Surgical interventions (anatomical correction vs conventional surgery) vs. No surgery or alternative surgical approaches was evaluated on Tricuspid regurgitation and mortality. Anatomical correction restoring a systemic left ventricle improved tricuspid regurgitation with 11% mortality, whereas conventional surgery leaving the right ventricle in systemic position had 33% mortality.

synapsesocial.com/papers/6a95cf809e192b00ba376b92https://doi.org/10.1136/hrt.80.5.479
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Combined atrial and arterial switch procedure for congenital corrected transposition with ventricular septal defect.1995 · 38 citations
  2. 2The spectrum of atrioventricular discordance. A clinical study.1984 · 26 citations
  3. 3Clinical Profile of Patients with Congenital Corrected Transposition of the Great Arteries1970 · 159 citations
  4. 4T. Duckett Jones Memorial Lecture. The Jones criteria and the challenges of clinimetrics.1982 · 222 citations