Efficacy of different treatment strategies for congenital aortic valve disease in 85 children from a single center: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Kun ,  JIA Bing

Cardiac Center, Children’s Hospital of Fudan University, Shanghai, 201102, P.R.China;

Corresponding?author：

JIA Bing, Email: Jiabing2012@hotmail.com

Keywords：

Aortic valve disease; surgery; children; retrospective cohort study

DOI：

10.7507/1007-4848.201912072

Video：

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Objective To analyze the early- and middle-term prognosis of various surgical methods in children with congenital aortic valve diseases, to provide reference for surgical methods in children with aortic valve stenosis or regurgitation.Methods The clinical data of 85 children with various aortic valve diseases treated in the Children’s Hospital of Fudan University from January 2005 to December 2018 were retrospectively analyzed. There were 64 males and 21 females, with an average age of 45 months ranging from 5 days to 15 years. Among them 18 patients underwent balloon aortic valvuloplasty (BAV), 8 surgical aortic valvotomy (SAV), 27 aortic valve autogenous pericardium repair, 16 mechanical arterial valve replacement and 16 Ross operation. They were followed up for 6.25±2.76 years. The re-intervention and survival status after different operations were analyzed.Results There were 3 deaths and 17 reoperations in 85 children. The 5-year survival rate of the patients with SAV, BAV, aortic valve autogenous pericardium repair, mechanical arterial valve replacement and Ross operation was 87.4%, 88.9%, 100.0%, 100.0% and 100.0%, respectively; there was no statistical difference in the early and middle-term survival rates among various operations (P>0.05). The 5-year free from re-intervention rate of the patients with SAV, BAV, aortic valve autogenous pericardium repair, mechanical arterial valve replacement and Ross operation was 44.4%, 18.4%, 100.0%, 66.9% and 80.5%, respectively; there was a statistical difference in the early and middle-term re-intervention rate among various operations (P<0.05).Conclusion The operation of congenital aortic stenosis or regurgitation needs to be performed according to the pathological changes of the valvular tissues. For children with severe lesions, SAV is recommended for the first intervention. For congenital aortic stenosis, SAV and BAV are both palliative operations which need further evaluation and re-intervention. Ross operation and mechanical arterial valve replacement have low re-intervention rate, and the middle- and long-term follow-up shows that the effect is accurate. Aortic valve autogenous pericardium repair is expected to become a method to delay or replace Ross operation and valve replacement.

Citation： WANG Kun, JIA Bing. Efficacy of different treatment strategies for congenital aortic valve disease in 85 children from a single center: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(3): 260-263. doi: 10.7507/1007-4848.201912072 Copy

1.	顧燕, 金梅, 丁文虹, 等. 兒童先天性主動脈瓣狹窄經皮主動脈瓣球囊成形術的近中期隨訪研究. 中國醫藥, 2018, 13(11): 1637-1641.
2.	褚恒, 唐楊烽, 徐志云, 等. 兒童主動脈瓣置換術近遠期療效分析. 國際心血管病雜志, 2017, 44(4): 236-240.
3.	賈兵. 自體心包修復兒童主動脈瓣病變. 中國循環雜志, 2015, (z1): 115.
4.	金晶, 華正東, 曾祥軍, 等. 單個主動脈瓣葉牛心包置換術治療兒童室間隔缺損合并主動脈瓣反流. 中國胸心血管外科臨床雜志, 2014, 21(2): 216-219.
5.	張善通, 陳張根, 賈兵. 小兒胸心外科學. 上海: 上海科學技術文獻出版社, 2007. 349-397.
6.	胡志德. AME 統計學專欄\|手把手教你如何解讀生存曲線. 臨床與病理雜志, 2015, 35(3): 349-352.
7.	Nishimura RA, Otto CM, Bonow RO, et al. AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, 2014, 129(23): 2440-2492.
8.	許迪. 主動脈瓣狹窄程度的超聲評估及分級. 廈門: 2018 海峽兩岸醫藥衛生交流與合作會議暨第十屆海峽兩岸超聲醫學高端論壇論文集, 2018. 17-41.
9.	Atik SU, Ero?lu AG, ?inar B, et al. Comparison of balloon dilatation and surgical valvuloplasty in non-critical congenital aortic valvular stenosis at long-term follow-up. Pediatr Cardiol, 2018, 39(8): 1554-1560.
10.	朱貴軍, 陳興澎, 王亞宏, 等. 兒童主動脈瓣病變的外科治療策略. 中華小兒外科雜志, 2017, 38(3): 178-181.
11.	王坤, 賈兵. 兒童主動脈瓣疾病手術治療進展. 中華外科雜志, 2018, 56(6): 414-417.
12.	Ozaki S, Kawase I, Yamashita H, et al. Aortic valve reconstruction using self-developed aortic valve plasty system in aortic valve disease. Interact Cardiovasc Thorac Surg, 2011, 12(4): 550-553.
13.	單亞平, 賈兵, 張惠鋒, 等. 自體心包修復兒童主動脈瓣狹窄 9 例病例系列報告. 中國循證兒科雜志, 2017, 12(4): 268-272.
14.	Mokhles MM, Rizopoulos D, Andrinopoulou ER, et al. Autograft and pulmonary allograft performance in the second post-operative decade after the Ross procedure: insights from the Rotterdam Prospective Cohort Study. Eur Heart J, 2012, 33(17): 2213-2224.
15.	Ross DN. Replacement of aortic and mitral valves with a pulmonary autograft. Lancet, 1967, 2(7523): 956-958.
16.	甘輝立, 張健群, 李繼勇, 等. 應用 ROSS 手術治療兒童主動脈瓣病變的研究. 中華小兒外科雜志, 2007, 28(8): 397-400.

1. 顧燕, 金梅, 丁文虹, 等. 兒童先天性主動脈瓣狹窄經皮主動脈瓣球囊成形術的近中期隨訪研究. 中國醫藥, 2018, 13(11): 1637-1641.
2. 褚恒, 唐楊烽, 徐志云, 等. 兒童主動脈瓣置換術近遠期療效分析. 國際心血管病雜志, 2017, 44(4): 236-240.
3. 賈兵. 自體心包修復兒童主動脈瓣病變. 中國循環雜志, 2015, (z1): 115.
4. 金晶, 華正東, 曾祥軍, 等. 單個主動脈瓣葉牛心包置換術治療兒童室間隔缺損合并主動脈瓣反流. 中國胸心血管外科臨床雜志, 2014, 21(2): 216-219.
5. 張善通, 陳張根, 賈兵. 小兒胸心外科學. 上海: 上海科學技術文獻出版社, 2007. 349-397.
6. 胡志德. AME 統計學專欄|手把手教你如何解讀生存曲線. 臨床與病理雜志, 2015, 35(3): 349-352.
7. Nishimura RA, Otto CM, Bonow RO, et al. AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, 2014, 129(23): 2440-2492.
8. 許迪. 主動脈瓣狹窄程度的超聲評估及分級. 廈門: 2018 海峽兩岸醫藥衛生交流與合作會議暨第十屆海峽兩岸超聲醫學高端論壇論文集, 2018. 17-41.
9. Atik SU, Ero?lu AG, ?inar B, et al. Comparison of balloon dilatation and surgical valvuloplasty in non-critical congenital aortic valvular stenosis at long-term follow-up. Pediatr Cardiol, 2018, 39(8): 1554-1560.
10. 朱貴軍, 陳興澎, 王亞宏, 等. 兒童主動脈瓣病變的外科治療策略. 中華小兒外科雜志, 2017, 38(3): 178-181.
11. 王坤, 賈兵. 兒童主動脈瓣疾病手術治療進展. 中華外科雜志, 2018, 56(6): 414-417.
12. Ozaki S, Kawase I, Yamashita H, et al. Aortic valve reconstruction using self-developed aortic valve plasty system in aortic valve disease. Interact Cardiovasc Thorac Surg, 2011, 12(4): 550-553.
13. 單亞平, 賈兵, 張惠鋒, 等. 自體心包修復兒童主動脈瓣狹窄 9 例病例系列報告. 中國循證兒科雜志, 2017, 12(4): 268-272.
14. Mokhles MM, Rizopoulos D, Andrinopoulou ER, et al. Autograft and pulmonary allograft performance in the second post-operative decade after the Ross procedure: insights from the Rotterdam Prospective Cohort Study. Eur Heart J, 2012, 33(17): 2213-2224.
15. Ross DN. Replacement of aortic and mitral valves with a pulmonary autograft. Lancet, 1967, 2(7523): 956-958.
16. 甘輝立, 張健群, 李繼勇, 等. 應用 ROSS 手術治療兒童主動脈瓣病變的研究. 中華小兒外科雜志, 2007, 28(8): 397-400.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Efficacy of different treatment strategies for congenital aortic valve disease in 85 children from a single center: A retrospective cohort study

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