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Atrioventricular valve closure in Fontan palliation
- Source :
- European Journal of Cardio-Thoracic Surgery. 57:945-950
- Publication Year :
- 2019
- Publisher :
- Oxford University Press (OUP), 2019.
-
Abstract
- OBJECTIVES Atrioventricular valve regurgitation is known to adversely impact outcomes of single-ventricle palliation, and valve repair rarely provides long-lasting results. Closure of a atrioventricular valve can sometimes be performed, but the long-term outcomes of this manoeuvre are unknown. METHODS This retrospective study was conducted using patient data extracted from an existing bi-national, population-based registry of survivors of the Fontan procedure. RESULTS Between January 1975 and June 2018, 1574 patients survived to hospital discharge with an intact Fontan circulation. Of these patients, 128 with a common atrioventricular valve were excluded. Thirty-eight patients underwent closure of an atrioventricular valve, and complete follow-up data were available for 36 patients. Twenty-nine patients underwent closure of the tricuspid valve and 7 patients underwent closure of the mitral valve. Seventeen patients underwent valve closure prior to Fontan, 13 patients underwent valve closure concomitant with Fontan and 6 patients underwent valve closure post-Fontan. Valve closure was performed using a patch technique in 29 cases and with direct suture in 7 cases. At the most recent echocardiography, 33 patients had no regurgitation, 2 patients had recurrent mild regurgitation and 1 patient had no echocardiographic follow-up. Six patients required reintervention post-valve closure and 7 patients required permanent pacemaker insertion post-valve closure. Freedom from reintervention at 1, 5 and 18 years post-valve closure was 86% [95% confidence interval (CI) 76–98%], 83% (95% CI 72–96%) and 83% (95% CI 72–96%), respectively. CONCLUSION Atrioventricular valve closure is an effective surgical technique in selected patients with a single ventricle providing long-lasting competency in the majority of cases.
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
Palliative care
medicine.medical_treatment
Population
Regurgitation (circulation)
030204 cardiovascular system & hematology
Fontan Procedure
Fontan procedure
03 medical and health sciences
0302 clinical medicine
Mitral valve
medicine
Humans
education
Retrospective Studies
Atrioventricular valve
education.field_of_study
Tricuspid valve
business.industry
Infant
General Medicine
Tricuspid Valve Insufficiency
Surgery
Treatment Outcome
medicine.anatomical_structure
030228 respiratory system
Ventricle
Tricuspid Valve
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 1873734X and 10107940
- Volume :
- 57
- Database :
- OpenAIRE
- Journal :
- European Journal of Cardio-Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....df90357683531f170104b8180dcac2a8