Surgical Management of Aorto-Ventricular Tunnel. A Multicenter Study
| Autor: | Protopapas, E.M., Anderson, R.H., Backer, C.L., Fragata, J., Hakim, N., Vida, V.L., Sarris, G.E., Barron, D.J., Berggren, H., Hazekamp, M.G., Ilyin, V., Kornoukhov, O.J., Kostolny, M., Lazarov, S., Rito, M. lo, Monge, M.C., Mykychak, Y., Nosal, M., Pretre, R., Polimenakos, A.C., Sojak, V., Stellin, G., Veshti, A., Yemets, I., ECHSA WSPCHS Study Grp |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Time Factors medicine.medical_treatment 030204 cardiovascular system & hematology Ventricular Function Left 0302 clinical medicine Aortic valve repair Postoperative Complications Child Aorta Surgical treatment General Medicine Aorto-ventricular tunnel Aortic orifice Aortic valvuloplasty Europe medicine.anatomical_structure Treatment Outcome Aortic valve stenosis Right coronary artery Aortic Valve Child Preschool cardiovascular system Female Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine Adult Heart Defects Congenital medicine.medical_specialty Adolescent Heart Ventricles 03 medical and health sciences Young Adult medicine.artery Ascending aorta medicine Humans Cardiac Surgical Procedures Coronary sinus Retrospective Studies business.industry Hemodynamics Infant Newborn Infant Recovery of Function medicine.disease United States Surgery 030228 respiratory system business |
| Zdroj: | Seminars in Thoracic and Cardiovascular Surgery, 32(2), 271-279. ELSEVIER INC |
| Popis: | Aorto-ventricular tunnel (AoVT), a rare congenital anomaly, is a channel originating in the ascending aorta just above the sinotubular junction and leading to the cavity of the left ventricle (AoLVT), or, rarely, the right (AoRVT). This study reviews our collective 30-year experience with the surgical treatment of AoVT. Data were submitted by 15 participating centers on 42 patients who underwent correction of AoVT between 1987 and 2018. Of these, 36 had AoLVT, and 6 AoRVT. The tunnel originated above the right coronary sinus in 28 (77.8%) patients. For AoLVT, most operations were performed early (median age 25 days, range: 1 day–25 years). In contrast, AoRVT was diagnosed and repaired later (median age 6 years, range: 1 month–12 years). Surgically important coronary ostial displacement was common. Patch closure of the aortic orifice only was the commonest surgical repair for AoLVT (23 patients), while in AoRVT, both orifices or only the ventricular one was closed. Aortic valvar insufficiency, severe or moderate, coexisted in 11 (30.5%) patients with AoLVT, and aortic valvuloplasty was performed in 8, mainly due to aortic valve stenosis. Aortic valvar insufficiency at discharge ranged from trivial to mild in almost all patients. Early mortality was 7.14%, with 3 patients with AoLVT succumbing to cardiac failure. There were 2 early reoperations and 1 late death. AoVT is a rare malformation. AoLVT usually necessitates surgery in early life. AoRVT is rarer, diagnosed and repaired later in life. Surgical repair by patch closure, with concomitant aortic valve repair as needed, is associated with good results. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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