Atrioventricular valve repair in patients with functional single-ventricle physiology: Impact of ventricular and valve function and morphology on survival.

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Presentation transcript:

Atrioventricular valve repair in patients with functional single-ventricle physiology: Impact of ventricular and valve function and morphology on survival and reintervention Osami Honjo, MD, PhD, Cori R. Atlin, BA, Luc Mertens, MD, PhD, Osman O. Al-Radi, MD, MSc, Andrew N. Redington, MD, Christopher A. Caldarone, MD, Glen S. Van Arsdell, MD The Journal of Thoracic and Cardiovascular Surgery Volume 142, Issue 2, Pages 326-335.e2 (August 2011) DOI: 10.1016/j.jtcvs.2010.11.060 Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Kaplan-Meier survival analyses of the single-ventricle patients undergoing atrioventricular (AV) valve repair. Cumulative (Cum) survivals are given by diagnosis (A), by ventricular morphology (B), by atrioventricular valve morphology (C), and among 4 subgroups determined according to postrepair residual atrioventricular valve insufficiency and ventricular function (D). AVSD, Atrioventricular septal defect; HLHS, hypoplastic left heart syndrome; TA/DILV, tricuspid atresia with double-inlet left ventricle; DORV, double-outlet right ventricle; LV, left ventricle; RV, right ventricle. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 326-335.e2DOI: (10.1016/j.jtcvs.2010.11.060) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Competing risk outcomes for the entire cohort. B, The flow chart for the 57 patients who underwent atrioventricular (AV) valve repair. SV, Single ventricle. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 326-335.e2DOI: (10.1016/j.jtcvs.2010.11.060) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Kaplan-Meier survival analysis comparing cumulative (Cum) survivals between the valve repair group and a case-matched control group. A, Entire cohort (n = 56). B, The subgroup of the valve repair group with successful repair with normal ventricular function (group 1, n = 41) and its matched control group. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 326-335.e2DOI: (10.1016/j.jtcvs.2010.11.060) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Changes in atrioventricular valve regurgitation grade before and after atrioventricular valve repair. The regurgitation grade was significantly reduced by the atrioventricular valve repair. Three of the 13 patients with severe atrioventricular valve insufficiency (23%) and 4 of the 38 patients with moderate atrioventricular valve insufficiency (10%) had moderate residual atrioventricular valve insufficiency (12% of the entire cohort). All the patients with mild to moderate regurgitation showed improvement to mild or trivial regurgitation. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 326-335.e2DOI: (10.1016/j.jtcvs.2010.11.060) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions