Thorac Cardiovasc Surg Rep 2014; 03(01): 016-018
DOI: 10.1055/s-0034-1387130
Case Report: Cardiac
Georg Thieme Verlag KG Stuttgart · New York

Valve-Sparing Reimplantation Technique for Treatment of Neoaortic Root Dilatation Late after the Arterial Switch Operation: Raising the Bar

Markus Liebrich
1   Department of Cardiac Surgery, Sana Cardiac Surgery Stuttgart, Stuttgart, Germany
2   Department of Congenital Cardiac Surgery, Sana Cardiac Surgery Stuttgart, Stuttgart, Germany
,
Michael Scheid
1   Department of Cardiac Surgery, Sana Cardiac Surgery Stuttgart, Stuttgart, Germany
2   Department of Congenital Cardiac Surgery, Sana Cardiac Surgery Stuttgart, Stuttgart, Germany
,
Frank Uhlemann
3   Department of Pediatric Cardiology/Pulmonology and Intensive Care Medicine, Klinikum Stuttgart Olgahospital, Stuttgart, Germany
,
Wolfgang B. Hemmer
1   Department of Cardiac Surgery, Sana Cardiac Surgery Stuttgart, Stuttgart, Germany
2   Department of Congenital Cardiac Surgery, Sana Cardiac Surgery Stuttgart, Stuttgart, Germany
› Author Affiliations
Further Information

Publication History

26 May 2014

16 June 2014

Publication Date:
04 September 2014 (online)

Abstract

Neoaortic root dilatation can develop during long-term follow-up after an arterial switch operation (ASO). Although few patients require surgical reintervention, significant valve regurgitation is still an important cause of late morbidity. We report on a 15-year-old boy with significant dilatation of the neoaortic root that was treated with the valve-sparing reimplantation technique. There is only one reported case of valve-preserving surgery late after the ASO. Valve preservation is believed to be superior to valve replacement in patients with aortic regurgitation due to better hemodynamic performance and avoidance of anticoagulation therapy.

 
  • References

  • 1 Castaneda AR, Norwood WI, Jonas RA, Colon SD, Sanders SP, Lang P. Transposition of the great arteries and intact ventricular septum: anatomical repair in the neonate. Ann Thorac Surg 1984; 38 (5) 438-443
  • 2 Khairy P, Clair M, Fernandes SM , et al. Cardiovascular outcomes after the arterial switch operation for D-transposition of the great arteries. Circulation 2013; 127 (3) 331-339
  • 3 Raju V, Burkhart HM, Durham III LA , et al. Reoperation after arterial switch: a 27-year experience. Ann Thorac Surg 2013; 95 (6) 2105-2112 , discussion 2112–2113
  • 4 Co-Vu JG, Ginde S, Bartz PJ, Frommelt PC, Tweddell JS, Earing MG. Long-term outcomes of the neoaorta after arterial switch operation for transposition of the great arteries. Ann Thorac Surg 2013; 95 (5) 1654-1659
  • 5 Liebrich M, Kruszynski MK, Roser D , et al. The David procedure in different valve pathologies: a single-center experience in 236 patients. Ann Thorac Surg 2013; 95 (1) 71-76
  • 6 Liebrich M, Weimar T, Tzanavaros I , et al. The David procedure for salvage of a failing autograft after the Ross operation: maintaining the principle of a living valve. Ann Thorac Surg 2014; ; In press
  • 7 Pees C, Laufer G, Michel-Behnke I. Similarities and differences of the aortic root after arterial switch and ross operation in children. Am J Cardiol 2013; 111 (1) 125-130
  • 8 Koolbergen DR, Manshanden JS, Yazdanbakhsh AP , et al. Reoperation for neoaortic root pathology after the arterial switch operation. Eur J Cardiothorac Surg 2014; (e-pub ahead of print). doi: DOI: 10.1093/ejtcs/ezu026.
  • 9 Izumoto H, Kawazoe K, Oka T, Kazui T, Kawase T, Nasu M. Aortic valve repair for aortic regurgitation: intermediate-term results in patients with tricuspid morphology. J Heart Valve Dis 2006; 15 (2) 169-173 , discussion 173
  • 10 Mazzitelli D, Nöbauer C, Rankin JS , et al. Early results of a novel technique for ring-reinforced aortic valve and root restoration. Eur J Cardiothorac Surg 2014; 45 (3) 426-430