{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:10:39Z","timestamp":1777878639115,"version":"3.51.4"},"reference-count":44,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T00:00:00Z","timestamp":1650499200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>During congenital heart surgery, the pulmonary valve and root may be placed into the systemic position, yielding a \u201cneoaortic\u201d valve. With the stress of systemic pressure, the pulmonary roots can dilate, creating aneurysms and\/or neoaortic insufficiency (neoAI). This report analyzes the early outcomes of patients undergoing neoaortic valve repair incorporating geometric ring annuloplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty-one patients underwent intended repair at six centers and formed the study cohort. Thirteen had previous Ross procedures, five had arterial switch operations, and three Fontan physiology. Average age was 21.7\u2009\u00b1\u200912.8 years (mean\u2009\u2009\u00b1\u2009\u2009SD), 80% were male, and 11 (55%) had symptomatic heart failure. Preoperative neoAI Grade was 3.1\u2009\u2009\u00b1\u2009\u20091.1, and annular diameter was 30.7\u2009\u2009\u00b1\u2009\u20096.5\u2005mm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Valve repair was accomplished in 20\/21, using geometric annuloplasty rings and leaflet plication (n\u2009=\u200913) and\/or nodular release (n\u2009=\u20097). Fourteen had neoaortic aneurysm replacement (13 with root remodeling). Two underwent bicuspid valve repair. Six had pulmonary conduit changes, one insertion of an artificial Nodulus Arantius, and one resection of a subaortic membrane. Ring size averaged 21.9\u2009\u2009\u00b1\u2009\u20092.3\u2005mm, and aortic clamp time was 171\u2009\u2009\u00b1\u2009\u200954\u2005minutes. No operative mortality or major morbidity occurred, and postoperative hospitalization was 4.3\u2009\u2009\u00b1\u2009\u20091.4 days. At discharge, neoAI grade was 0.2\u2009\u2009\u00b1\u2009\u20090.4 ( P\u2009&lt;\u2009.0001), and valve mean gradient was \u226420 mm Hg. At average 18.0\u2009\u2009\u00b1\u2009\u20099.1 months of follow-up, all patients were asymptomatic with stable valve function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neoaortic aneurysms and neoAI are occasionally seen late following Ross, arterial switch, or Fontan procedures. Neoaortic valve repair using geometric ring annuloplasty, leaflet reconstruction, and root remodeling provides a patient-specific approach with favorable early outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501351221079523","type":"journal-article","created":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T08:46:18Z","timestamp":1650530778000},"page":"304-309","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Early Outcomes of Patients Undergoing Neoaortic Valve Repair Incorporating Geometric Ring Annuloplasty"],"prefix":"10.1177","volume":"13","author":[{"given":"John P.","family":"Kupferschmid","sequence":"first","affiliation":[{"name":"Methodist Children\u2019s Hospital, San Antonio. TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph W.","family":"Turek","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. Chad","family":"Hughes","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"Erle H.","family":"Austin","sequence":"additional","affiliation":[{"name":"University of Louisville, Louisville, KY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bahaaldin","family":"Alsoufi","sequence":"additional","affiliation":[{"name":"University of Louisville, Louisville, KY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Michael","family":"Smith","sequence":"additional","affiliation":[{"name":"The Christ Hospital, Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank G.","family":"Scholl","sequence":"additional","affiliation":[{"name":"Joe Dimaggio Children\u2019s Hospital, Hollywood, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Scott","family":"Rankin","sequence":"additional","affiliation":[{"name":"West Virginia University, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinay","family":"Badhwar","sequence":"additional","affiliation":[{"name":"West Virginia University, Morgantown, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan M.","family":"Chen","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad A.","family":"Nuri","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer C.","family":"Romano","sequence":"additional","affiliation":[{"name":"University of Michigan, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard 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