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Pediatric Cardiology

, Volume 37, Issue 6, pp 1022–1027 | Cite as

The Impact of Aortic Valve Replacement on Left Ventricular Remodeling in Children

  • Anoop K. SinghEmail author
  • Ross M. Ungerleider
  • Yuk M. Law
Original Article

Abstract

There are scant data in pediatrics on the optimal timing for aortic valve repair (AVR). This study assesses the midterm response to AVR and possible predictors of poor outcome. From 2001 to 2006, 41 patients had greater than 3-month follow-up after AVR for aortic insufficiency, aortic stenosis, or both. Pre-, peri-, and post-operative data were collected, including demographics and clinical symptoms. Two reviewers measured echocardiographic parameters from the pre-operative and latest follow-up echocardiograms. Ventricular dimensions were indexed to body surface area (z-score). Median age at AVR was 13 years with 83 % having a Ross operation. The average left ventricular end-diastolic dimension pre-op, z-score of +1.3, significantly decreased at last follow-up to a mean z-score of −0.1 (p < 0.001). Similarly the indexed LV mass decreased from +3.9 to +0.5 (p < 0.001). There was no significant correlation between the presence of pre-op symptoms and the presence of post-op LV dilatation, hypertrophy, or dysfunction. In the subset of patients (7/41) with persistent LV dysfunction at last follow-up, there was a significant correlation with pre-op LV dilatation as assessed by both LVEDD (p = 0.02) and LVESD (p = 0.05). Children demonstrate significant reverse remodeling after AVR. Pre-op LV dilatation may predict patients with persistent LV dysfunction post-AVR. Symptoms are less useful in children, suggesting the need for more objective data for functional assessment.

Keywords

Aortic valve replacement Aortic insufficiency Aortic stenosis Ventricular remodeling Pediatrics 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Anoop K. Singh
    • 1
    Email author
  • Ross M. Ungerleider
    • 2
  • Yuk M. Law
    • 3
  1. 1.Division of Pediatric CardiologyMedical College of WisconsinMilwaukeeUSA
  2. 2.Brenner Children’s HospitalWake Forest UniversityWinston SalemUSA
  3. 3.Department of Pediatrics, Seattle Children’s HospitalUniversity of WashingtonSeattleUSA

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