Abstract

OBJECTIVES

Different methods of aortic valve repair have been described in the literature for aortic regurgitation (AR) associated with doubly committed subarterial ventricular septal defects. Our goal was to present our experience with aortic valve reconstruction of a single leaflet using the aortic valve neocuspidization technique in this subset of patients.

METHODS

It is a retrospective review of 7 patients with doubly committed subarterial ventricular septal defects with significant (>moderate) AR who underwent the single-leaflet neocuspidization technique of aortic valve reconstruction from January 2016 to January 2019. Data were collected from medical records. All patients had thorough 2-dimensional echocardiographic assessment preoperatively and during the follow-up period. Primary end points were freedom from postoperative AR and freedom from reoperation and all-cause mortality within the follow-up period with secondary end points of freedom from thromboembolism and infective endocarditis.

RESULTS

Out of 7 patients, 6 were male and 1 was female. There were no perioperative deaths. The mean follow-up period was 2.6 ± 0.8 years. No deaths occurred during the follow-up period. At the latest follow-up examination, only 2 patients showed mild AR and were asymptomatic. There was no documented event of infective endocarditis or thromboembolism during the follow-up period.

CONCLUSIONS

The aortic leaflet neocuspidization procedure for the aortic valve is a relatively new concept. Availability of a template makes it an easily reproducible valve repair in paediatric patients with a single-leaflet abnormality. This technique preserves the remaining 2 normal leaflets, thus promoting the growth potential while maintaining near normal aortic root complex dynamics.

中文翻译：

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主动脉瓣新尖瓣化治疗与室间隔缺损相关的主动脉瓣关闭不全

摘要

目标

文献中已经描述了与双重动脉下室间隔缺损相关的主动脉瓣关闭不全 (AR) 的不同主动脉瓣修复方法。我们的目标是展示我们在这部分患者中使用主动脉瓣新尖瓣化技术对单叶进行主动脉瓣重建的经验。

方法

这是对 2016 年 1 月至 2019 年 1 月接受单叶新尖瓣重建主动脉瓣重建技术的 7 例双重动脉下室间隔缺损伴显着（>中度）AR 患者的回顾性研究。数据来自医疗记录。所有患者术前和随访期间均进行了全面的二维超声心动图评估。主要终点是无术后 AR、无再手术和随访期间的全因死亡率，次要终点是无血栓栓塞和感染性心内膜炎。

结果

7例患者中，男性6例，女性1例。没有围手术期死亡。平均随访时间为 2.6 ± 0.8 年。随访期间无死亡病例。在最近的随访检查中，只有 2 名患者出现轻度 AR 且无症状。在随访期间没有记录到感染性心内膜炎或血栓栓塞事件。

结论

主动脉瓣的主动脉瓣新尖瓣化手术是一个相对较新的概念。模板的可用性使其成为具有单叶异常的儿科患者的易于重现的瓣膜修复。该技术保留了剩余的 2 个正常瓣叶，从而促进了生长潜力，同时保持了接近正常的主动脉根部复合体动力学。