{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:54:17Z","timestamp":1789779257144,"version":"4.0.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T00:00:00Z","timestamp":1600992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"National Institute for Health Research (NIHR) Bristol Cardiovascular Biomedical Research Centre"},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute for Cardiovascular Outcomes Research"},{"name":"National Congenital Heart Disease Audit"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Some patients with complex congenital heart disease (cCHD) also require aortic valve (AoV) procedures. These cases are considered high risk but their outcome has not been well characterized. We aim to describe these scenarios in the current practice, and provide outcome data for counselling and decision-making.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This was a retrospective study using the UK National Congenital Heart Disease Audit data on cCHD patients undergoing aortic valve replacement, balloon dilation (balloon aortic valvuloplasty) or surgical repair (surgical aortic valve repair) between 2000 and 2012. Coarsened exact matching was used to pair cCHD with patients undergoing AoV procedures for isolated valve disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 201 patients with a varied spectrum of cCHD undergoing 242 procedures were included, median age 9.4\u2009years (1\u2009day\u201365\u2009years). Procedure types were: balloon aortic valvuloplasty (n\u2009=\u200931, 13%), surgical aortic valve repair (n\u2009=\u200957, 24%) and aortic valve replacement (n\u2009=\u2009154, 63%). Mortality at 30\u2009days was higher in neonates (21.8% vs 5.3%, P\u2009=\u20090.02). Survival at 10\u2009years was 83.1%, freedom from aortic valve replacement 83.8% and freedom from balloon aortic valvuloplasty\/surgical aortic valve repair 86.3%. Neonatal age (P\u2009&amp;lt;\u20090.001), single ventricle (P\u2009=\u20090.08), concomitant Fontan\/Glenn (P\u2009=\u20090.002) or aortic arch procedures (0.02) were associated with higher mortality. cCHD patients had lower survival at 30\u2009days (93% vs 100%, P\u2009=\u20090.003) and at 10\u2009years (86.4% vs 96.1%, P\u2009=\u20090.005) compared to matched isolated AoV disease patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>AoV procedures in cCHD can be performed with good results outside infancy, but with higher mortality than in isolated AoV disease. Neonates and patients with single ventricle defects, especially those undergoing concomitant Fontan\/Glenn, have worse outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivaa130","type":"journal-article","created":{"date-parts":[[2020,6,21]],"date-time":"2020-06-21T11:15:33Z","timestamp":1592738133000},"page":"547-554","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes following aortic valve procedures in 201 complex congenital heart disease cases\u2014results from the UK National Audit"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2443-1019","authenticated-orcid":false,"given":"Dan M","family":"Dorobantu","sequence":"first","affiliation":[{"name":"Department of Paediatric Cardiac Surgery, Heart Institute, Bristol Royal Hospital for Children, Bristol, UK"},{"name":"Faculty of Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7740-0465","authenticated-orcid":false,"given":"Alexandru C","family":"Visan","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3180-6993","authenticated-orcid":false,"given":"Robert M R","family":"Tulloh","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiac Surgery, Heart Institute, Bristol Royal Hospital for Children, Bristol, UK"},{"name":"Faculty of Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4294-5446","authenticated-orcid":false,"given":"Francisco","family":"Gonzalez-Barlatay","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiac Surgery, Heart Institute, Bristol Royal Hospital for Children, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Caputo","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiac Surgery, Heart Institute, Bristol Royal Hospital for Children, Bristol, UK"},{"name":"Faculty of Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serban C","family":"Stoica","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiac Surgery, Heart Institute, Bristol Royal Hospital for Children, Bristol, UK"},{"name":"Faculty of Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,9,25]]},"reference":[{"key":"2020102213253868400_ivaa130-B1","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1016\/S0735-1097(01)01272-4","article-title":"Task force 1: the changing profile of congenital heart disease in adult life","volume":"37","author":"Warnes","year":"2001","journal-title":"J Am Coll Cardiol"},{"key":"2020102213253868400_ivaa130-B2","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.jtcvs.2018.08.077","article-title":"Outcomes after mechanical aortic valve replacement in children and young adults with congenital heart disease","volume":"157","author":"Myers","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2020102213253868400_ivaa130-B3","doi-asserted-by":"crossref","first-page":"2915","DOI":"10.1093\/eurheartj\/ehq249","article-title":"ESC guidelines for the management of grown-up congenital heart disease (new version 2010)","volume":"31","author":"Baumgartner","year":"2010","journal-title":"Eur Heart J"},{"key":"2020102213253868400_ivaa130-B4","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jtcvs.2014.05.014","article-title":"2014 AHA\/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association task force on practice guidelines","volume":"148","author":"Nishimura","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2020102213253868400_ivaa130-B5","doi-asserted-by":"crossref","first-page":"I152","DOI":"10.1161\/hc37t1.094837","article-title":"Are outcomes of surgical versus transcatheter balloon valvotomy equivalent in neonatal critical aortic stenosis?","volume":"104","author":"McCrindle","year":"2001","journal-title":"Circulation"},{"key":"2020102213253868400_ivaa130-B6","doi-asserted-by":"crossref","first-page":"2858","DOI":"10.1016\/j.jacc.2016.04.021","article-title":"Aortic valve replacement and the ross operation in children and young adults","volume":"67","author":"Sharabiani","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2020102213253868400_ivaa130-B7","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/S1010-7940(00)00324-9","article-title":"Aortic valve replacement in children: are mechanical prostheses a good option?","volume":"17","author":"Alexiou","year":"2000","journal-title":"Eur J Cardiothorac Surg"},{"key":"2020102213253868400_ivaa130-B8","doi-asserted-by":"crossref","first-page":"e000938","DOI":"10.1136\/openhrt-2018-000938","article-title":"Surgical versus balloon valvotomy in neonates and infants: results from the UK National Audit","volume":"6","author":"Dorobantu","year":"2019","journal-title":"Open Heart"},{"key":"2020102213253868400_ivaa130-B9","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1093\/ejechocard\/jeq085","article-title":"Growth of left heart structures following the hybrid procedure for borderline hypoplastic left heart","volume":"11","author":"Ballard","year":"2010","journal-title":"Eur J Echocardiogr"},{"key":"2020102213253868400_ivaa130-B10","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1016\/S0003-4975(98)00803-0","article-title":"Biventricular repair in neonates with hypoplastic left heart complex","volume":"66","author":"Tchervenkov","year":"1998","journal-title":"Ann Thorac Surg"},{"key":"2020102213253868400_ivaa130-B11","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1016\/j.jtcvs.2012.07.038","article-title":"Aortic root and valve surgery after arterial switch operation","volume":"144","author":"Fricke","year":"2012","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2020102213253868400_ivaa130-B12","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.ejcts.2008.06.019","article-title":"Risk factors for aortic insufficiency and aortic valve replacement after the arterial switch operation","volume":"34","author":"Lange","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"key":"2020102213253868400_ivaa130-B13","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1016\/j.jtcvs.2014.11.075","article-title":"Long-term fate of the aortic valve after an arterial switch operation","volume":"149","author":"Rito","year":"2015","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2020102213253868400_ivaa130-B14","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.athoracsur.2018.06.002","article-title":"Arterial switch operation: operative approach and outcomes","volume":"107","author":"Fricke","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2020102213253868400_ivaa130-B15","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1016\/j.jacc.2010.06.040","article-title":"Aortic valve reinterventions after balloon aortic valvuloplasty for congenital aortic stenosis: intermediate and late follow-up","volume":"56","author":"Brown","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2020102213253868400_ivaa130-B16","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1016\/j.jtcvs.2010.10.024","article-title":"Arterial switch operation in children with interrupted aortic arch: long-term outcomes","volume":"141","author":"Fricke","year":"2011","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2020102213253868400_ivaa130-B17","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/S0022-5223(97)70232-0","article-title":"Aortic valve replacement after repair of pulmonary atresia and ventricular septal defect or tetralogy of fallot","volume":"113","author":"Dodds","year":"1997","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2020102213253868400_ivaa130-B18","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1093\/icvts\/ivu163","article-title":"Successful Bentall procedure in a patient with a Fontan circulation","volume":"19","author":"Spadotto","year":"2014","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2020102213253868400_ivaa130-B19","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/j.ijcard.2016.08.006","article-title":"First successful trans-catheter aortic-valve replacement for native aortic stenosis in atrio-pulmonary Fontan","volume":"222","author":"Yeong","year":"2016","journal-title":"Int J Cardiol"},{"key":"2020102213253868400_ivaa130-B20","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1016\/S0003-4975(01)03017-X","article-title":"Tetralogy of Fallot with aortic valvular stenosis: surgical correction in one case","volume":"73","author":"Ghez","year":"2002","journal-title":"Ann Thorac Surg"},{"key":"2020102213253868400_ivaa130-B21","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1016\/S0735-1097(02)01886-7","article-title":"The incidence of congenital heart disease","volume":"39","author":"Hoffman","year":"2002","journal-title":"J Am Coll Cardiol"},{"key":"2020102213253868400_ivaa130-B22","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1177\/1536867X0900900402","article-title":"Cem: coarsened exact matching in Stata","volume":"9","author":"Blackwell","year":"2009","journal-title":"Stata J"},{"key":"2020102213253868400_ivaa130-B23","doi-asserted-by":"crossref","first-page":"e000157","DOI":"10.1136\/openhrt-2014-000157","article-title":"Trends in 30-day mortality rate and case mix for paediatric cardiac surgery in the UK between 2000 and 2010","volume":"2","author":"Brown","year":"2015","journal-title":"Open Heart"},{"key":"2020102213253868400_ivaa130-B24","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1093\/ejcts\/ezx172","article-title":"Contemporary results of aortic valve repair for congenital disease: lessons for management and staged strategy","volume":"52","author":"Vergnat","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"key":"2020102213253868400_ivaa130-B25","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1056\/NEJMoa0912461","article-title":"Comparison of shunt types in the Norwood procedure for single-ventricle lesions","volume":"362","author":"Ohye","year":"2010","journal-title":"N Engl J Med"},{"key":"2020102213253868400_ivaa130-B26","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1093\/ejcts\/ezs477","article-title":"Congenitally corrected transposition of the great arteries with coexisting aortic valve stenosis in a 77-year-old woman","volume":"43","author":"Matsumura","year":"2013","journal-title":"Eur J Cardiothorac Surg"},{"key":"2020102213253868400_ivaa130-B27","doi-asserted-by":"crossref","first-page":"E13","DOI":"10.1111\/j.1540-8175.2011.01522.x","article-title":"Congenitally corrected transposition of the great arteries with severely stenotic bicuspid aortic valve in an adult: a case report","volume":"29","author":"Pino","year":"2012","journal-title":"Echocardiography"},{"key":"2020102213253868400_ivaa130-B28","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/0002-8703(68)90260-3","article-title":"Malformations of the aortic valve in patients with the tetralogy of Fallot","volume":"76","author":"Glancy","year":"1968","journal-title":"Am Heart J"},{"key":"2020102213253868400_ivaa130-B29","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/S0003-4975(10)61699-2","article-title":"Tetralogy of Fallot associated with aortic insufficiency","volume":"29","author":"Matsuda","year":"1980","journal-title":"Ann Thorac Surg"},{"key":"2020102213253868400_ivaa130-B30","doi-asserted-by":"crossref","first-page":"1979","DOI":"10.1016\/0002-9149(82)90218-1","article-title":"Aortic regurgitation in tetrad of Fallot and pulmonary atresia","volume":"49","author":"Capelli","year":"1982","journal-title":"Am J Cardiol"}],"container-title":["Interactive CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/icvts\/article-pdf\/31\/4\/547\/33989261\/ivaa130.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/icvts\/article-pdf\/31\/4\/547\/33989261\/ivaa130.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T17:26:22Z","timestamp":1603387582000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/31\/4\/547\/5911406"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,25]]},"references-count":30,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,9,25]]},"published-print":{"date-parts":[[2020,10,1]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivaa130","relation":{},"ISSN":["1569-9285"],"issn-type":[{"value":"1569-9285","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,10]]},"published":{"date-parts":[[2020,9,25]]}}}