Objective:Ventricle septal defect(VSD)is commonly associated with aortic regurgitation and aortic leaflet prolapse due to anatomic and hemodynamic factors.The concomitant intervention of the aortic valve during VSD re...Objective:Ventricle septal defect(VSD)is commonly associated with aortic regurgitation and aortic leaflet prolapse due to anatomic and hemodynamic factors.The concomitant intervention of the aortic valve during VSD repair remains one of the major concerns.Moreover,little is known about the structure and hemodynamic change in the presence of postoperative progressive AR after VSD repair.Methods:From August 2012 to February 2019,VSD patients with aortic regurgitation who underwent VSD surgical repair with or without aortic valve intervention in our institution were retrospectively reviewed.Preoperative echo and postoperative echo in the followup were collected and compared.Results:The mean age of the patients on VSD repair was 3.2.Those with postoperative progressive aortic regurgitation showed significantly increased right atrium,mean pulmonary artery,valve flow velocity,and A-wave velocity,and significantly reduced right ventricle outflow tract and descending aorta flow velocity(P<0.05).Additionally,compared with no AR intervention,aortic valvuloplasty during VSD repair predispose patients to have progressive AR(P<0.05).Conclusion:There was augmented capacity in the right-heart system and increased valvular flow velocity in the left-heart system in VSD patients combined with postoperative AR.Additional aortic valvuloplasty or aortic valve replacement during surgical VSD repair might not be necessary,especially for those with no or mild AR preoperatively.Aortic valve replacement,if required,is a more appropriate alternative in halting postoperative AR progression than aortic valvuloplasty.展开更多
Background Objective:The aorta root dilation remains one of the major concerns in surgical management for patients with unrepaired or repaired tetralogy of Fallot.The present study was sought to characterize the evolu...Background Objective:The aorta root dilation remains one of the major concerns in surgical management for patients with unrepaired or repaired tetralogy of Fallot.The present study was sought to characterize the evolution of aorta root dilation after tetralogy of Fallot repair in a long-term follow-up and determine the necessity of simultaneous intervention or reoperation on the dilated aortic root.Methods:We retrospectively reviewed a total of 100consecutive patients undergoing intra-cardiac tetralogy of Fallot repair in Guangdong Provincial People’s Hospital from Jan 2010 to Jan 2015.Operation records and transthoracic echocardiography data including initial preoperative assessment and a series of postoperative visits were all collected and compared.Results:Of the 100 consecutive patients(24.9±13.3 years,51 male),40%and 55%underwent ventricular septal defect repair with an operational approach on the right atrium incision and right ventricle outflow tract incision,respectively.The aorta root dimension decreased shortly after tetralogy of Fallot repair(P=0.01)but significantly augmented in the second postoperative follow-up(P=0.02),with no distinct change in the next several postoperative follow-ups.Conclusion:The aorta root dilation in patients after late tetralogy of Fallot repair is common but seems stable in a long-term follow-up,suggesting that it might not necessitate surgical correction during or after repairing the tetralogy of Fallot,especially for those without preoperative aortic root dilation.展开更多
基金supported by the Project of Guangdong Provincial Clinical Research Center for Cardiovascular disease(No.2020B1111170011)Guangdong Special Funds for Science and Technology Innovation Strategy,China(Stability Support for Scientific Research Institutions Affiliated to Guangdong Province-GDCI 2021)Guangdong Peak Project(No.DFJH201802)
文摘Objective:Ventricle septal defect(VSD)is commonly associated with aortic regurgitation and aortic leaflet prolapse due to anatomic and hemodynamic factors.The concomitant intervention of the aortic valve during VSD repair remains one of the major concerns.Moreover,little is known about the structure and hemodynamic change in the presence of postoperative progressive AR after VSD repair.Methods:From August 2012 to February 2019,VSD patients with aortic regurgitation who underwent VSD surgical repair with or without aortic valve intervention in our institution were retrospectively reviewed.Preoperative echo and postoperative echo in the followup were collected and compared.Results:The mean age of the patients on VSD repair was 3.2.Those with postoperative progressive aortic regurgitation showed significantly increased right atrium,mean pulmonary artery,valve flow velocity,and A-wave velocity,and significantly reduced right ventricle outflow tract and descending aorta flow velocity(P<0.05).Additionally,compared with no AR intervention,aortic valvuloplasty during VSD repair predispose patients to have progressive AR(P<0.05).Conclusion:There was augmented capacity in the right-heart system and increased valvular flow velocity in the left-heart system in VSD patients combined with postoperative AR.Additional aortic valvuloplasty or aortic valve replacement during surgical VSD repair might not be necessary,especially for those with no or mild AR preoperatively.Aortic valve replacement,if required,is a more appropriate alternative in halting postoperative AR progression than aortic valvuloplasty.
基金supported by the Project of Guangdong Provincial Clinical Research Center for Cardiovascular disease(No.2020B1111170011)Guangdong Special Funds for Science and Technology Innovation Strategy,China(Stability Support for Scientific Research Institutions Affiliated to Guangdong Province-GDCI 2021)Guangdong Peak Project(No.DFJH201802)。
文摘Background Objective:The aorta root dilation remains one of the major concerns in surgical management for patients with unrepaired or repaired tetralogy of Fallot.The present study was sought to characterize the evolution of aorta root dilation after tetralogy of Fallot repair in a long-term follow-up and determine the necessity of simultaneous intervention or reoperation on the dilated aortic root.Methods:We retrospectively reviewed a total of 100consecutive patients undergoing intra-cardiac tetralogy of Fallot repair in Guangdong Provincial People’s Hospital from Jan 2010 to Jan 2015.Operation records and transthoracic echocardiography data including initial preoperative assessment and a series of postoperative visits were all collected and compared.Results:Of the 100 consecutive patients(24.9±13.3 years,51 male),40%and 55%underwent ventricular septal defect repair with an operational approach on the right atrium incision and right ventricle outflow tract incision,respectively.The aorta root dimension decreased shortly after tetralogy of Fallot repair(P=0.01)but significantly augmented in the second postoperative follow-up(P=0.02),with no distinct change in the next several postoperative follow-ups.Conclusion:The aorta root dilation in patients after late tetralogy of Fallot repair is common but seems stable in a long-term follow-up,suggesting that it might not necessitate surgical correction during or after repairing the tetralogy of Fallot,especially for those without preoperative aortic root dilation.
