Mid-term result of atrioventricular valve replacement in patients with a single ventricle

Koichi Sughimoto, Yasutaka Hirata, Norimichi Hirahara, Hiroaki Miyata, Takaaki Suzuki, Arata Murakami, Kagami Miyaji, Shinichi Takamoto

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVES: Atrioventricular valve replacement is the last option to treat the atrioventricular valve regurgitation in single ventricle. This study investigates the mid-term outcomes of the atrioventricular valve replacement based on the Japan Cardiovascular Surgery Database registry. METHODS: From 2008 to 2014, 56 patients [34 males (61%) and 22 females (39%)] with a single ventricular circulation, underwent atrioventricular valve replacement. Questionnaires were collected to review operative data, mid-term mortality, morbidity and redo replacement. Risk factor analysis was performed by the Cox regression model for death and redo replacement. RESULTS: Heterotaxy, a right systemic ventricle and a common atrioventricular valve was present in 46% (26/56), 64% and 57% of patients, respectively. The most common timings for atrioventricular valve replacement were the interstage between the second and third palliations (34%) and after the Fontan operation (34%). Twenty died during the 3.7 ± 2.6-year follow-up. Eleven received redo atrioventricular replacement. The cumulative incidences of redo atrioventricular valve replacement and survival at 3 years were 20% [95% confidence interval (CI) 9-30] and 66% (95% CI 55-80), respectively. Univariable Cox regression analysis revealed that a tricuspid valve was a risk factor for redo valve replacement [hazard ratio (HR) 6.76, 95% CI 1.79-25.6; P = 0.005] and that young age was a risk factor for death (HR 0.77, 95% CI 0.62-0.96; P = 0.019). Fourteen patients required a pacemaker implantation. CONCLUSIONS: Valve replacement for uncontrollable atrioventricular valve regurgitation in single ventricular circulation was associated with a moderately high risk of death, redo replacement and pacemaker implantation, whereas valve replacement at a later period and with a larger prosthetic valve size was associated with low mortality.

Original languageEnglish
Pages (from-to)895-900
Number of pages6
JournalInteractive Cardiovascular and Thoracic Surgery
Volume27
Issue number6
DOIs
Publication statusPublished - 2018 Dec 1

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Confidence Intervals
Fontan Procedure
Tricuspid Valve
Mortality
Proportional Hazards Models
Statistical Factor Analysis
Heart Ventricles
Registries
Japan
Regression Analysis
Databases
Morbidity
Survival
Incidence
Surveys and Questionnaires

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Mid-term result of atrioventricular valve replacement in patients with a single ventricle. / Sughimoto, Koichi; Hirata, Yasutaka; Hirahara, Norimichi; Miyata, Hiroaki; Suzuki, Takaaki; Murakami, Arata; Miyaji, Kagami; Takamoto, Shinichi.

In: Interactive Cardiovascular and Thoracic Surgery, Vol. 27, No. 6, 01.12.2018, p. 895-900.

Research output: Contribution to journalArticle

Sughimoto, Koichi ; Hirata, Yasutaka ; Hirahara, Norimichi ; Miyata, Hiroaki ; Suzuki, Takaaki ; Murakami, Arata ; Miyaji, Kagami ; Takamoto, Shinichi. / Mid-term result of atrioventricular valve replacement in patients with a single ventricle. In: Interactive Cardiovascular and Thoracic Surgery. 2018 ; Vol. 27, No. 6. pp. 895-900.
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abstract = "OBJECTIVES: Atrioventricular valve replacement is the last option to treat the atrioventricular valve regurgitation in single ventricle. This study investigates the mid-term outcomes of the atrioventricular valve replacement based on the Japan Cardiovascular Surgery Database registry. METHODS: From 2008 to 2014, 56 patients [34 males (61{\%}) and 22 females (39{\%})] with a single ventricular circulation, underwent atrioventricular valve replacement. Questionnaires were collected to review operative data, mid-term mortality, morbidity and redo replacement. Risk factor analysis was performed by the Cox regression model for death and redo replacement. RESULTS: Heterotaxy, a right systemic ventricle and a common atrioventricular valve was present in 46{\%} (26/56), 64{\%} and 57{\%} of patients, respectively. The most common timings for atrioventricular valve replacement were the interstage between the second and third palliations (34{\%}) and after the Fontan operation (34{\%}). Twenty died during the 3.7 ± 2.6-year follow-up. Eleven received redo atrioventricular replacement. The cumulative incidences of redo atrioventricular valve replacement and survival at 3 years were 20{\%} [95{\%} confidence interval (CI) 9-30] and 66{\%} (95{\%} CI 55-80), respectively. Univariable Cox regression analysis revealed that a tricuspid valve was a risk factor for redo valve replacement [hazard ratio (HR) 6.76, 95{\%} CI 1.79-25.6; P = 0.005] and that young age was a risk factor for death (HR 0.77, 95{\%} CI 0.62-0.96; P = 0.019). Fourteen patients required a pacemaker implantation. CONCLUSIONS: Valve replacement for uncontrollable atrioventricular valve regurgitation in single ventricular circulation was associated with a moderately high risk of death, redo replacement and pacemaker implantation, whereas valve replacement at a later period and with a larger prosthetic valve size was associated with low mortality.",
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T1 - Mid-term result of atrioventricular valve replacement in patients with a single ventricle

AU - Sughimoto, Koichi

AU - Hirata, Yasutaka

AU - Hirahara, Norimichi

AU - Miyata, Hiroaki

AU - Suzuki, Takaaki

AU - Murakami, Arata

AU - Miyaji, Kagami

AU - Takamoto, Shinichi

PY - 2018/12/1

Y1 - 2018/12/1

N2 - OBJECTIVES: Atrioventricular valve replacement is the last option to treat the atrioventricular valve regurgitation in single ventricle. This study investigates the mid-term outcomes of the atrioventricular valve replacement based on the Japan Cardiovascular Surgery Database registry. METHODS: From 2008 to 2014, 56 patients [34 males (61%) and 22 females (39%)] with a single ventricular circulation, underwent atrioventricular valve replacement. Questionnaires were collected to review operative data, mid-term mortality, morbidity and redo replacement. Risk factor analysis was performed by the Cox regression model for death and redo replacement. RESULTS: Heterotaxy, a right systemic ventricle and a common atrioventricular valve was present in 46% (26/56), 64% and 57% of patients, respectively. The most common timings for atrioventricular valve replacement were the interstage between the second and third palliations (34%) and after the Fontan operation (34%). Twenty died during the 3.7 ± 2.6-year follow-up. Eleven received redo atrioventricular replacement. The cumulative incidences of redo atrioventricular valve replacement and survival at 3 years were 20% [95% confidence interval (CI) 9-30] and 66% (95% CI 55-80), respectively. Univariable Cox regression analysis revealed that a tricuspid valve was a risk factor for redo valve replacement [hazard ratio (HR) 6.76, 95% CI 1.79-25.6; P = 0.005] and that young age was a risk factor for death (HR 0.77, 95% CI 0.62-0.96; P = 0.019). Fourteen patients required a pacemaker implantation. CONCLUSIONS: Valve replacement for uncontrollable atrioventricular valve regurgitation in single ventricular circulation was associated with a moderately high risk of death, redo replacement and pacemaker implantation, whereas valve replacement at a later period and with a larger prosthetic valve size was associated with low mortality.

AB - OBJECTIVES: Atrioventricular valve replacement is the last option to treat the atrioventricular valve regurgitation in single ventricle. This study investigates the mid-term outcomes of the atrioventricular valve replacement based on the Japan Cardiovascular Surgery Database registry. METHODS: From 2008 to 2014, 56 patients [34 males (61%) and 22 females (39%)] with a single ventricular circulation, underwent atrioventricular valve replacement. Questionnaires were collected to review operative data, mid-term mortality, morbidity and redo replacement. Risk factor analysis was performed by the Cox regression model for death and redo replacement. RESULTS: Heterotaxy, a right systemic ventricle and a common atrioventricular valve was present in 46% (26/56), 64% and 57% of patients, respectively. The most common timings for atrioventricular valve replacement were the interstage between the second and third palliations (34%) and after the Fontan operation (34%). Twenty died during the 3.7 ± 2.6-year follow-up. Eleven received redo atrioventricular replacement. The cumulative incidences of redo atrioventricular valve replacement and survival at 3 years were 20% [95% confidence interval (CI) 9-30] and 66% (95% CI 55-80), respectively. Univariable Cox regression analysis revealed that a tricuspid valve was a risk factor for redo valve replacement [hazard ratio (HR) 6.76, 95% CI 1.79-25.6; P = 0.005] and that young age was a risk factor for death (HR 0.77, 95% CI 0.62-0.96; P = 0.019). Fourteen patients required a pacemaker implantation. CONCLUSIONS: Valve replacement for uncontrollable atrioventricular valve regurgitation in single ventricular circulation was associated with a moderately high risk of death, redo replacement and pacemaker implantation, whereas valve replacement at a later period and with a larger prosthetic valve size was associated with low mortality.

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