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Common atrioventricular valve failure during single ventricle palliation.
- Source :
-
European Journal of Cardio-Thoracic Surgery . Jun2017, Vol. 51 Issue 6, p1037-1043. 7p. - Publication Year :
- 2017
-
Abstract
- 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). Twentyfive 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 rerepairs, 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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 10107940
- Volume :
- 51
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- European Journal of Cardio-Thoracic Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 123171169
- Full Text :
- https://doi.org/10.1093/ejcts/ezx025