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      Valve-Sparing Reimplantation Technique for Treatment of Neoaortic Root Dilatation Late after the Arterial Switch Operation: Raising the Bar

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          Abstract

          Neoaortic root dilatation can develop during long-term follow-up after an arterial switch operation (ASO). Although few patients require surgical reintervention, significant valve regurgitation is still an important cause of late morbidity. We report on a 15-year-old boy with significant dilatation of the neoaortic root that was treated with the valve-sparing reimplantation technique. There is only one reported case of valve-preserving surgery late after the ASO. Valve preservation is believed to be superior to valve replacement in patients with aortic regurgitation due to better hemodynamic performance and avoidance of anticoagulation therapy.

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          Transposition of the great arteries and intact ventricular septum: anatomical repair in the neonate.

          W Norwood, S. Sanders, R Jonas … (1984)
          Fourteen neonates 18 hours to 32 days old with transposition of the great arteries (TGA) and virtually intact ventricular septum (IVS) underwent arterial switch operations under deep hypothermic circulatory arrest. Preoperative left ventricular to right ventricular peak systolic pressure ratios ranged from 0.7 to 1.0 (mean, 0.92), and the echocardiogram showed a centrally positioned ventricular septum in 10 patients and a rightward displaced ventricular septum in 4. One patient died twelve hours after operation. Postoperative complications included bleeding from the left coronary artery-pulmonary artery anastomosis (1 patient), stenosis of the pulmonary artery-aorta anastomosis requiring reoperation (2 patients), transient ST segment and T wave abnormalities consistent with ischemia (3), and development of pathological Q waves suggestive of clinically silent infarction (2). The capacity of the left ventricle in a neonate to effectively take over the systemic circulation was clearly demonstrated. A longer follow-up period is needed to assess late ventricular function, coronary ostial growth, growth of the aorta-pulmonary artery anastomosis, late aortic valve (anatomical pulmonary valve) function before definitive recommendations about the superiority of the arterial switch operation in neonates with TGA plus IVS can be formulated.
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            Reoperation after arterial switch: a 27-year experience.

            Vijayakumar Raju, Harold Burkhart, Lucian Durham … (2013)
            The long-term outcome and spectrum of reoperation after the arterial switch operation (ASO) has not been fully defined, and there are limited data in the literature. We reviewed our institutional experience with reoperation(s) after ASO.
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              Long-term outcomes of the neoaorta after arterial switch operation for transposition of the great arteries.

              Jennifer Co-Vu, Salil Ginde, Peter Bartz … (2013)
              After the arterial switch operation (ASO) for transposition of the great arteries (TGA), the native pulmonary root and valve function in the systemic position, and the long-term risk for neoaortic root dilation and valve regurgitation is currently undefined. The aim of this study was to determine the prevalence and progression of neoaortic root dilation and neoaortic valve regurgitation in patients with TGA repaired with the ASO.
              Article 0 comments Cited 12 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Thorac Cardiovasc Surg Rep
                Journal ID (iso-abbrev): Thorac Cardiovasc Surg Rep
                Journal ID (doi): 10.1055/s-00024355
                Title: The Thoracic and Cardiovascular Surgeon Reports
                Publisher: Georg Thieme Verlag KG (Stuttgart · New York )
                ISSN (Print): 2194-7635
                ISSN (Electronic): 2194-7643
                Publication date (Electronic): 04 September 2014
                Publication date (Print): December 2014
                Volume: 3
                Issue: 1
                Pages: 16-18
                Affiliations
                [1 ]Department of Cardiac Surgery, Sana Cardiac Surgery Stuttgart, Stuttgart, Germany
                [2 ]Department of Congenital Cardiac Surgery, Sana Cardiac Surgery Stuttgart, Stuttgart, Germany
                [3 ]Department of Pediatric Cardiology/Pulmonology and Intensive Care Medicine, Klinikum Stuttgart Olgahospital, Stuttgart, Germany
                Author notes
                Address for correspondence Ioannis Tzanavaros, MD Department of Cardiac Surgery Sana Cardiac Surgery Stuttgart, Herdweg 2 Stuttgart 70174Germany i.tzanavaros@ 123456sana.de
                Article
                Publisher ID: 140099crc
                DOI: 10.1055/s-0034-1387130
                PMC ID: 4360663
                SO-VID: 24f9cb5d-c238-40b9-9a7b-1b1209235a08
                Copyright © © Thieme Medical Publishers
                History
                Date received : 26 May 2014
                Date accepted : 16 June 2014
                Categories
                Subject: Article

                Keywords: transposition of the great arteries,arterial switch operation,valve-sparing reimplantation technique
                Data availability:
                Keywords: transposition of the great arteries, arterial switch operation, valve-sparing reimplantation technique

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