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

6 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

Keywords

  • Congenital heart disease
  • Fontan
  • Single ventricle
  • Valve replacement

ASJC Scopus subject areas

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

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