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Pediatric Cardiology

, Volume 40, Issue 4, pp 813–819 | Cite as

Does Coronary Reimplantation After Neoaortic Reconstruction Increase Aortic Regurgitation?

  • Kwang Ho Choi
  • Si Chan SungEmail author
  • Hyungtae Kim
  • Hyoung Doo Lee
  • Geena Kim
  • Hoon Ko
  • Joung-Hee Byun
  • Young Seok Lee
Original Article
  • 62 Downloads

Abstract

Coronary reimplantation after neoaortic reconstruction (CRANR) in the arterial switch operation (ASO) allows easy selection of accurate coronary transfer sites in the distended neoaorta. However, neoaortic valve injury may occur during coronary reimplantation. We determined whether the CRANR procedure increased the incidence of aortic valve regurgitation (AR) after ASO. Between March 1994 and August 2017, 227 patients underwent ASO. Since September 2000 CRANR has been performed on 155 patients and open coronary reimplantation (OCR) on 72. Patients who had undergone aortocoronary flaps procedures (n = 13), had early or late mortality (n = 27), or lacked data (n = 11) were excluded. We enrolled and retrospectively reviewed the medical records of 176 patients who were followed up for postoperative AR: 38 underwent OCR and 138 underwent CRANR. We compared the incidences of early and late postoperative AR in both groups. We defined mild or greater AR as “significant AR.” The groups did not differ in body weight at operation, great artery relationship, and coronary artery anatomy. The incidences of significant AR at discharge were 21.1% (8/38) in the OCR group and 16.6% (23/138) in the CRANR group (p = 0.53). The freedom from significant AR at 5 years was 59.9% in the OCR group and 62.4% in the CRANR group with no difference between the two groups (p = 0.73). Moderate AR occurred in one patient in the CRANR group. No surgical intervention was required for the aortic valve in either group. ASO using the CRANR technique did not increase the incidence of postoperative early and late AR.

Keywords

Arterial switch operation Aortic valve regurgitation Coronary implantation Transposition of the great artery 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Kwang Ho Choi
    • 1
  • Si Chan Sung
    • 1
    Email author
  • Hyungtae Kim
    • 1
  • Hyoung Doo Lee
    • 2
  • Geena Kim
    • 2
  • Hoon Ko
    • 2
  • Joung-Hee Byun
    • 2
  • Young Seok Lee
    • 3
  1. 1.Department of Thoracic and Cardiovascular Surgery, Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan HospitalYangsanRepublic of Korea
  2. 2.Department of Pediatrics, Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan HospitalYangsanRepublic of Korea
  3. 3.Department of PediatricsDong-A University HospitalBusanSouth Korea

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