Predictors of left ventricular outflow tract obstruction after conventional repair for patients with interrupted aortic arch or coarctation of the aorta, combined with ventricular septal defect : a single-center experience

2022
journal article
article
4
dc.abstract.enLeft ventricular outflow tract obstruction (LVOTO) affects survival and reoperation rates after surgical treatment of patients with interruption of the aortic arch (IAA) or coarctation of the aorta (CoA) with ventricular septal defect (VSD). The aim of the study was to determine predictors of LVOTO and to evaluate the relationship between aortic valve (AoV) morphology and the re-intervention rate. Retrospective review of patients, who underwent a conventional repair for IAA/CoA with VSD at a tertiary referral center between 1996 and 2017. The preoperative demographic data as well as pre- and post-operative echocardiographic parameters and re-interventions were reviewed. In the median follow-up of 8.3 years (range of 6.15–10.27) 5 patients (11.9%) from a total of 47 patients included in the study presented with a significant LVOTO. Four of them required reoperation after median period of 2.3 years (range of 0.3–7.9) after the initial surgery. Multivariable logistic regression identified AoV z-score (OR 0.44, p = 0.017) as predictor of LVOTO. The mean AoV z-score before the primary repair was significantly smaller in those with LVOTO as compared to those with unobstructed flow from the LV (− 3.58 ± 1.96 vs. − 1.44 ± 1.55; p = 0.0016). At 1-year follow-up, both groups showed an increase in the AoV z-score (p = 0.98). The re-intervention rate after primary repair (both surgical procedures and percutaneous interventions), either for LVOTO or reCoA, was higher in patients with AoV z-score ≤  − 3 (p = 0.007 vs. p = 0.46) and those, whose aortic annulus was less or equal than patient’s weight (kg) + 1.5 mm as compared to those with larger aortic annulus (p = 0.03 vs. p = 0.16). In patients after surgical treatment of IAA/CoA with VSD, the AoV z-score at diagnosis is a significant risk factor for reoperation for LVOTO. With age, AoV growth and z-score improvement is expected. Small AoV at diagnosis is correlated with increased rate of re-intervention for LVOTO and reCoA.
dc.affiliationWydział Lekarski : Instytut Pediatriipl
dc.cm.date2022-04-08T06:13:50Z
dc.cm.id106504pl
dc.cm.idOmegaUJCM1e75dce51ec04d9e927824cadaa43295pl
dc.contributor.authorSzafik, Katarzynapl
dc.contributor.authorGóreczny, Sebastian - 442464 pl
dc.contributor.authorOstrowska, Katarzynapl
dc.contributor.authorKazmierczak, Piotrpl
dc.contributor.authorMoll, Maciejpl
dc.contributor.authorMoll, Jadwiga A.pl
dc.date.accession2022-02-01pl
dc.date.accessioned2022-04-08T06:13:50Z
dc.date.available2022-04-08T06:13:50Z
dc.date.issued2022pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.number3pl
dc.description.physical525-531pl
dc.description.versionostateczna wersja wydawcy
dc.description.volume43pl
dc.identifier.doi10.1007/s00246-021-02749-0pl
dc.identifier.eissn1432-1971pl
dc.identifier.issn0172-0643pl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/290032
dc.identifier.weblinkhttps://link.springer.com/article/10.1007%2Fs00246-021-02749-0pl
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa 4.0 Międzynarodowa
dc.rights.licenceCC-BY
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/legalcode.pl
dc.share.typeinne
dc.subject.enleft ventricular outflow tract obstruction
dc.subject.eninterrupted aortic arch
dc.subject.encoarctation of the aorta
dc.subject.enaortic valve
dc.subtypeArticlepl
dc.titlePredictors of left ventricular outflow tract obstruction after conventional repair for patients with interrupted aortic arch or coarctation of the aorta, combined with ventricular septal defect : a single-center experiencepl
dc.title.journalPediatric Cardiologypl
dc.typeJournalArticlepl
dspace.entity.typePublication
dc.abstract.en
Left ventricular outflow tract obstruction (LVOTO) affects survival and reoperation rates after surgical treatment of patients with interruption of the aortic arch (IAA) or coarctation of the aorta (CoA) with ventricular septal defect (VSD). The aim of the study was to determine predictors of LVOTO and to evaluate the relationship between aortic valve (AoV) morphology and the re-intervention rate. Retrospective review of patients, who underwent a conventional repair for IAA/CoA with VSD at a tertiary referral center between 1996 and 2017. The preoperative demographic data as well as pre- and post-operative echocardiographic parameters and re-interventions were reviewed. In the median follow-up of 8.3 years (range of 6.15–10.27) 5 patients (11.9%) from a total of 47 patients included in the study presented with a significant LVOTO. Four of them required reoperation after median period of 2.3 years (range of 0.3–7.9) after the initial surgery. Multivariable logistic regression identified AoV z-score (OR 0.44, p = 0.017) as predictor of LVOTO. The mean AoV z-score before the primary repair was significantly smaller in those with LVOTO as compared to those with unobstructed flow from the LV (− 3.58 ± 1.96 vs. − 1.44 ± 1.55; p = 0.0016). At 1-year follow-up, both groups showed an increase in the AoV z-score (p = 0.98). The re-intervention rate after primary repair (both surgical procedures and percutaneous interventions), either for LVOTO or reCoA, was higher in patients with AoV z-score ≤  − 3 (p = 0.007 vs. p = 0.46) and those, whose aortic annulus was less or equal than patient’s weight (kg) + 1.5 mm as compared to those with larger aortic annulus (p = 0.03 vs. p = 0.16). In patients after surgical treatment of IAA/CoA with VSD, the AoV z-score at diagnosis is a significant risk factor for reoperation for LVOTO. With age, AoV growth and z-score improvement is expected. Small AoV at diagnosis is correlated with increased rate of re-intervention for LVOTO and reCoA.
dc.affiliationpl
Wydział Lekarski : Instytut Pediatrii
dc.cm.date
2022-04-08T06:13:50Z
dc.cm.idpl
106504
dc.cm.idOmegapl
UJCM1e75dce51ec04d9e927824cadaa43295
dc.contributor.authorpl
Szafik, Katarzyna
dc.contributor.authorpl
Góreczny, Sebastian - 442464
dc.contributor.authorpl
Ostrowska, Katarzyna
dc.contributor.authorpl
Kazmierczak, Piotr
dc.contributor.authorpl
Moll, Maciej
dc.contributor.authorpl
Moll, Jadwiga A.
dc.date.accessionpl
2022-02-01
dc.date.accessioned
2022-04-08T06:13:50Z
dc.date.available
2022-04-08T06:13:50Z
dc.date.issuedpl
2022
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.numberpl
3
dc.description.physicalpl
525-531
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
43
dc.identifier.doipl
10.1007/s00246-021-02749-0
dc.identifier.eissnpl
1432-1971
dc.identifier.issnpl
0172-0643
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/290032
dc.identifier.weblinkpl
https://link.springer.com/article/10.1007%2Fs00246-021-02749-0
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights
Udzielam licencji. Uznanie autorstwa 4.0 Międzynarodowa
dc.rights.licence
CC-BY
dc.rights.uri
http://creativecommons.org/licenses/by/4.0/legalcode.pl
dc.share.type
inne
dc.subject.en
left ventricular outflow tract obstruction
dc.subject.en
interrupted aortic arch
dc.subject.en
coarctation of the aorta
dc.subject.en
aortic valve
dc.subtypepl
Article
dc.titlepl
Predictors of left ventricular outflow tract obstruction after conventional repair for patients with interrupted aortic arch or coarctation of the aorta, combined with ventricular septal defect : a single-center experience
dc.title.journalpl
Pediatric Cardiology
dc.typepl
JournalArticle
dspace.entity.type
Publication
Affiliations

* The migration of download and view statistics prior to the date of April 8, 2024 is in progress.

Views
26
Views per month
Views per city
Ashburn
10
Krakow
2
Wroclaw
2
Dublin
1
Downloads
goreczny_et-al_predictors_of_left_ventricular_outflow_tract_2022.pdf
1