Mid-term outcomes of atrioventricular valve repair in functional single ventricle patients

BackgroundSurgical treatment of functional single ventricle combined with atrioventricular valve regurgitation remains a clinical challenge. The outcomes of atrioventricular valve repair in patients with single ventricle are limited.MethodsA retrospective study was conducted of all 28 patients with...

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Main Authors: Yong-Qiang Jin, Qing-Yu Wu, Xiao-Ya Zhang, Li-Xin Fan, En-Rui Zhang, Hui Xue, Ming-Kui Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2024.1510143/full
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author Yong-Qiang Jin
Yong-Qiang Jin
Qing-Yu Wu
Qing-Yu Wu
Xiao-Ya Zhang
Xiao-Ya Zhang
Li-Xin Fan
En-Rui Zhang
Hui Xue
Ming-Kui Zhang
Ming-Kui Zhang
author_facet Yong-Qiang Jin
Yong-Qiang Jin
Qing-Yu Wu
Qing-Yu Wu
Xiao-Ya Zhang
Xiao-Ya Zhang
Li-Xin Fan
En-Rui Zhang
Hui Xue
Ming-Kui Zhang
Ming-Kui Zhang
author_sort Yong-Qiang Jin
collection DOAJ
description BackgroundSurgical treatment of functional single ventricle combined with atrioventricular valve regurgitation remains a clinical challenge. The outcomes of atrioventricular valve repair in patients with single ventricle are limited.MethodsA retrospective study was conducted of all 28 patients with functional single ventricle treated with single-ventricle palliation who underwent atrioventricular valve operation at the First Hospital of Tsinghua University between April 2007 and October 2022.ResultsIn our cohort, the female/male ratio was 7:21, with an average age of 8.7 ± 6.0 (0.75–26) years. Half of patients (50%) were right-ventricle type for single-ventricle morphology. 18 patients (64.3%) were with a common atrioventricular valve. Twenty-three patients (82.1%) were combined with heterotaxy syndrome. Pre-operatively, twenty-four patients (85.7%) were diagnosed with severe atrioventricular valve regurgitation. AVV was repaired at the Glenn (n = 16, 57.1%), Glenn-Fontan (n = 2, 7.1%) and Fontan (n = 10, 35.7%) stage, respectively. Valve plastic techniques included valve annulus/commissure constriction (n = 24), clefts repair (9 cases), edge-to-edge suturing (13 cases) and common atrioventricular valve separation (4 cases). The early mortality was 3.6% (1/28). All survival patients were observed with improved regurgitation situations. Twenty-two patients (78.5%) were observed with no more than mild regurgitation postoperatively. The mean follow-up time was 5.4 ± 2.9 years (range, 3.08–11.83 years), with late mortality of 11.1% (3/27). All these three cases were observed with a severe regurgitation by echocardiogram in the last follow-up. Besides, reoperation rate of this cohort was 3.6% (1/28).ConclusionsAVV repair could significantly improve AVV function in SV patients combined with severe AVVR, with satisfactory mid-term results. Part of the cohort showed poor prognosis due to repeated AVVR. Regular follow-up by echocardiogram is critically important for these patients.
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spelling doaj-art-ea979a389e484f7fad3e0b4c1555c1ca2025-08-20T02:37:21ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2024-12-011110.3389/fcvm.2024.15101431510143Mid-term outcomes of atrioventricular valve repair in functional single ventricle patientsYong-Qiang Jin0Yong-Qiang Jin1Qing-Yu Wu2Qing-Yu Wu3Xiao-Ya Zhang4Xiao-Ya Zhang5Li-Xin Fan6En-Rui Zhang7Hui Xue8Ming-Kui Zhang9Ming-Kui Zhang10Heart Center, The First Hospital of Tsinghua University, Beijing, ChinaSchool of Clinical Medicine, Tsinghua University, Beijing, ChinaHeart Center, The First Hospital of Tsinghua University, Beijing, ChinaSchool of Clinical Medicine, Tsinghua University, Beijing, ChinaHeart Center, The First Hospital of Tsinghua University, Beijing, ChinaSchool of Clinical Medicine, Tsinghua University, Beijing, ChinaHeart Center, The First Hospital of Tsinghua University, Beijing, ChinaHeart Center, The First Hospital of Tsinghua University, Beijing, ChinaHeart Center, The First Hospital of Tsinghua University, Beijing, ChinaHeart Center, The First Hospital of Tsinghua University, Beijing, ChinaSchool of Clinical Medicine, Tsinghua University, Beijing, ChinaBackgroundSurgical treatment of functional single ventricle combined with atrioventricular valve regurgitation remains a clinical challenge. The outcomes of atrioventricular valve repair in patients with single ventricle are limited.MethodsA retrospective study was conducted of all 28 patients with functional single ventricle treated with single-ventricle palliation who underwent atrioventricular valve operation at the First Hospital of Tsinghua University between April 2007 and October 2022.ResultsIn our cohort, the female/male ratio was 7:21, with an average age of 8.7 ± 6.0 (0.75–26) years. Half of patients (50%) were right-ventricle type for single-ventricle morphology. 18 patients (64.3%) were with a common atrioventricular valve. Twenty-three patients (82.1%) were combined with heterotaxy syndrome. Pre-operatively, twenty-four patients (85.7%) were diagnosed with severe atrioventricular valve regurgitation. AVV was repaired at the Glenn (n = 16, 57.1%), Glenn-Fontan (n = 2, 7.1%) and Fontan (n = 10, 35.7%) stage, respectively. Valve plastic techniques included valve annulus/commissure constriction (n = 24), clefts repair (9 cases), edge-to-edge suturing (13 cases) and common atrioventricular valve separation (4 cases). The early mortality was 3.6% (1/28). All survival patients were observed with improved regurgitation situations. Twenty-two patients (78.5%) were observed with no more than mild regurgitation postoperatively. The mean follow-up time was 5.4 ± 2.9 years (range, 3.08–11.83 years), with late mortality of 11.1% (3/27). All these three cases were observed with a severe regurgitation by echocardiogram in the last follow-up. Besides, reoperation rate of this cohort was 3.6% (1/28).ConclusionsAVV repair could significantly improve AVV function in SV patients combined with severe AVVR, with satisfactory mid-term results. Part of the cohort showed poor prognosis due to repeated AVVR. Regular follow-up by echocardiogram is critically important for these patients.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1510143/fullsingle-ventricleatrioventricular valve repairFontanGlennoperation timing
spellingShingle Yong-Qiang Jin
Yong-Qiang Jin
Qing-Yu Wu
Qing-Yu Wu
Xiao-Ya Zhang
Xiao-Ya Zhang
Li-Xin Fan
En-Rui Zhang
Hui Xue
Ming-Kui Zhang
Ming-Kui Zhang
Mid-term outcomes of atrioventricular valve repair in functional single ventricle patients
Frontiers in Cardiovascular Medicine
single-ventricle
atrioventricular valve repair
Fontan
Glenn
operation timing
title Mid-term outcomes of atrioventricular valve repair in functional single ventricle patients
title_full Mid-term outcomes of atrioventricular valve repair in functional single ventricle patients
title_fullStr Mid-term outcomes of atrioventricular valve repair in functional single ventricle patients
title_full_unstemmed Mid-term outcomes of atrioventricular valve repair in functional single ventricle patients
title_short Mid-term outcomes of atrioventricular valve repair in functional single ventricle patients
title_sort mid term outcomes of atrioventricular valve repair in functional single ventricle patients
topic single-ventricle
atrioventricular valve repair
Fontan
Glenn
operation timing
url https://www.frontiersin.org/articles/10.3389/fcvm.2024.1510143/full
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