{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T16:20:36Z","timestamp":1769012436643,"version":"3.49.0"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The En-bloc Rotation of the Outflow Tracts, as suggested by Anderson in 20161, is a surgical approach for complex congenital heart defects, particularly in patients with transposition of the great arteries and associated ventricular septal defect and left ventricular outflow tract (LVOT) obstruction (LVOTO). Despite its effectiveness, concerns have arisen following a study by Stoica et al. (2022), which reported that 16% of patients developed at least moderate aortic regurgitation (AR) post-surgery. The mechanisms behind this complication remain unclear. This case report presents a 4-year-old patient who developed significant AR (grade 3+\/4), with left ventricular dilation (LVEDD: 43 mm), 3 years after an En-bloc Rotation, necessitating aortic valve repair. Initial echocardiography showed trivial AR, with progression of AR within 18 months and associated annular dilation (24 mm). The repair procedure involved plication of the LVOT, annuloplasty, and leaflet adjustments. At discharge, residual AR was mild to moderate (1+\/4). Seven months later, echocardiography revealed stable left ventricular dimensions and moderate AR (grade: 2+\/4). This case emphasizes the need for early detection and intervention for AR in patients after En-bloc Rotation surgery. Further research is needed to identify predisposing factors and refine surgical strategies.<\/jats:p>","DOI":"10.1093\/icvts\/ivaf240","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:57:56Z","timestamp":1760140676000},"source":"Crossref","is-referenced-by-count":1,"title":["Complex Aortic Valve Repair After En-Bloc Rotation of the Outflow Tracts: A Case Report"],"prefix":"10.1093","volume":"40","author":[{"given":"Andrea","family":"Rapagnani","sequence":"first","affiliation":[{"name":"Universit\u00e9 Catholique de Louvain, Cliniques Universitaires Saint-Luc, Department of Cardiothoracic and Vascular Surgery, Brussels, 1200,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gebrine","family":"El Khoury","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Catholique de Louvain, Cliniques Universitaires Saint-Luc, Department of Cardiothoracic and Vascular Surgery, Brussels, 1200,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1965-2335","authenticated-orcid":false,"given":"Mona","family":"Momeni","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Catholique de Louvain, Cliniques Universitaires Saint-Luc, Department of Anaesthesiology, Brussels, 1200,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain Jean","family":"Poncelet","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Catholique de Louvain, Cliniques Universitaires Saint-Luc, Department of Cardiothoracic and Vascular Surgery, Brussels, 1200,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,10,10]]},"reference":[{"key":"2025101606513068700_ivaf240-B1","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1093\/ejcts\/ezw088","article-title":"Rotation of the ventricular outflow tracts","volume":"50","author":"Anderson","year":"2016","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025101606513068700_ivaf240-B2","doi-asserted-by":"publisher","first-page":"1249","DOI":"10.1016\/j.jtcvs.2022.05.047","article-title":"Aortic root translocation and en bloc rotation of the outflow tracts surgery for complex forms of transposition of the great arteries and double outlet right ventricle: a multicenter study","volume":"164","author":"Stoica","year":"2022","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025101606513068700_ivaf240-B3","doi-asserted-by":"publisher","first-page":"1391","DOI":"10.1016\/j.jtcvs.2023.09.038","article-title":"Outcomes of neo-aortic valve and root surgery late after arterial switch operation","volume":"167","author":"Zhu","year":"2024","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025101606513068700_ivaf240-B4","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1007\/s00380-020-01729-3","article-title":"Predictors of neo-aortic valve regurgitation in the long term after arterial switch operation","volume":"36","author":"Takada","year":"2021","journal-title":"Heart Vessels"},{"key":"2025101606513068700_ivaf240-B5","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1093\/ejcts\/ezv050","article-title":"The role of annular dimension and annuloplasty in tricuspid aortic valve repair","volume":"49","author":"De Kerchove","year":"2016","journal-title":"Eur J Cardiothorac Surg"}],"container-title":["Interdisciplinary CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article-pdf\/doi\/10.1093\/icvts\/ivaf240\/64632538\/ivaf240.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/40\/10\/ivaf240\/64632538\/ivaf240.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/40\/10\/ivaf240\/64632538\/ivaf240.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T10:51:36Z","timestamp":1760611896000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/doi\/10.1093\/icvts\/ivaf240\/8281784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":5,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10,6]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivaf240","relation":{},"ISSN":["2753-670X"],"issn-type":[{"value":"2753-670X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,10]]},"published":{"date-parts":[[2025,10]]},"article-number":"ivaf240"}}