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Shone's anomaly: Operative results and late outcome
- Source :
- The Annals of Thoracic Surgery. 49:887-893
- Publication Year :
- 1990
- Publisher :
- Elsevier BV, 1990.
-
Abstract
- Shone's anomaly, a congenital cardiac malformation, consists of multiple levels of left heart obstruction including supravalvar mitral ring, parachute mitral valve, subaortic stenosis, and coarctation. The prognosis for patients with Shone's anomaly is poor. To assess operative results and late outcome, we reviewed the records of 30 consecutive patients seen with Shone's anomaly at our institution between 1966 and 1989. Anatomical diagnoses in these patients were supravalvar mitral ring (22 patients), mitral valve abnormalities including parachute mitral valve, fused chordae, or single papillary muscle (26 patients), subaortic gradients (26 patients), and coarctation (29 patients). Nineteen patients had all four lesions. Other common defects were bicuspid aortic valve (19 patients) and ventricular septal defect (20). Two patients were treated medically. The other 28 patients required 84 operative procedures with 18 patients undergoing more than one procedure. Operations included coarctation repair (28 patients), mitral valve repair or replacement (11), ventricular septal defect closure (8), subaortic resection (8), and complex left ventricular outflow tract reconstruction or bypass (4). Age at first operation ranged from 7 days to 7 years (median age, 3 months). There were no operative deaths at the first operation. However, mortality rose to 24% (4/17) after the second operation. All operative deaths were secondary to severe mitral valve disease. The survivors have been followed from 1 to 16 years (mean follow-up, 6 +/- 1 years). There were no late or sudden deaths. Morbidity has included stroke (1), gastrointestinal bleeding (2), permanent heart block (1), and persistent congestive heart failure (6).(ABSTRACT TRUNCATED AT 250 WORDS)
- Subjects :
- Heart Defects, Congenital
Male
Reoperation
Pulmonary and Respiratory Medicine
Cardiac Catheterization
medicine.medical_specialty
Time Factors
Heart block
medicine.medical_treatment
Blood Pressure
Aortic Coarctation
Postoperative Complications
Bicuspid aortic valve
Recurrence
Mitral valve
Internal medicine
medicine
Humans
Ventricular outflow tract
cardiovascular diseases
Child
Papillary muscle
Retrospective Studies
Cardiac catheterization
Mitral valve repair
business.industry
Infant, Newborn
Infant
Aortic Valve Stenosis
Syndrome
medicine.disease
Surgery
medicine.anatomical_structure
Child, Preschool
Heart failure
cardiovascular system
Cardiology
Mitral Valve
Female
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 00034975
- Volume :
- 49
- Database :
- OpenAIRE
- Journal :
- The Annals of Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....d5d0321d42b1aedaff7734ef6d114a69