Key result
Valve-sparing root replacement in children yields low mortality and leaves 94% free from AR.
Why the study?
Does valve-sparing root replacement using the reimplantation technique prevent mortality and recurrent aortic regurgitation in paediatric patients?
Cohort (n=19)
No
Does valve-sparing root replacement using the reimplantation technique prevent mortality and recurrent aortic regurgitation in paediatric patients?
Valve-sparing root replacement using the reimplantation technique is safe in children and yields stable mid-term results, though concurrent cusp repair may increase the risk of recurrent aortic regurgitation.
Supports valve-sparing root replacement in children; leaves open durability beyond 4 years and randomized comparisons.
OBJECTIVES: In children, words of caution have been raised about valve-sparing procedures especially regarding the valve-remodelling technique. This study reviewed our experience with the valve-sparing reimplantation technique in children. METHODS: All consecutive paediatric (<18 years) patients who underwent valve-sparing root replacement in our centre in the past 12.5 years were retrospectively analysed. RESULTS: Nineteen patients (median age 13.2 years, 10 months to 17.9 years) underwent valve-sparing root replacement using the reimplantation technique. Seventeen had connective tissue disease. An adult-sized vascular prosthesis could be implanted in all cases. Additional cusp repair was required in 3 patients. Follow-up was 4.4 ± 3.8 years. There was no perioperative mortality and one late death. Of the 3 patients that needed cusp repair, 1 developed Grade 3 aortic valve regurgitation (AR) and required aortic valve replacement and 2 had Grade 1 AR. Ninety-four percent of the other patients had Grade 0 AR at latest follow-up, 1 patient (6%) had Grade 1 AR. CONCLUSIONS: Our data show that valve-sparing root surgery using the reimplantation technique can be performed safely in children. Mid-term follow-up yields stable and favourable results. When leaflet reconstruction is necessary on top of the reimplantation procedure, rate of recurrent AR seems to be higher.
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Kluin et al. (2016) conducted a cohort in Aortic root disease (n=19). Valve-sparing root replacement using the reimplantation technique was evaluated on Perioperative mortality, late death, and aortic valve regurgitation. Valve-sparing root replacement using the reimplantation technique in children resulted in 0 perioperative mortality, 1 late death, and 94% of non-cusp repair patients having Grade 0 AR at 4.4 years.
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