{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:12:52Z","timestamp":1777878772874,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"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":[[2026,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    To improve understanding of indications and outcomes for cardiac surgery for rheumatic aortic valvular disease in the young.\n                    <jats:bold>Methods:<\/jats:bold>\n                    Single institution retrospective cohort aged\u2009&lt;\u200918 years with rheumatic heart disease who underwent surgery for isolated rheumatic aortic valve disease between 2000 and 2019. Baseline, intermediate follow-up, and late follow-up data were collected. Left ventricular (LV) dysfunction defined as LV ejection fraction\u2009&lt;\u200955% or LV shortening fraction\u2009&lt;\u200927%.\n                    <jats:bold>Results:<\/jats:bold>\n                    Thirty-nine patients who were 8 to 18 years of age were included (median age 14 years), weighing 27 to 157 kg (median 78 kg) with follow up of 2 to 15 years (median 7 years). Index operations were valve repair 6 of 39 (15%), valve replacement 33 of 39 (84%) with homograft (n\u2009=\u200920), and mechanical valve (13). The 30-day mortality was zero. Overall mortality was 8 of 39 (20%); 17 of 39 (43%) underwent reoperation. At intermediate and late follow up, 27% (7\/26) and 53% (18\/34) had persistent dysfunction, respectively. Baseline LV dysfunction increased the risk of death (hazard ratio 13.3 [1.52-115.5],\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.003), which increased adjusting for higher body surface area (BSA). All those with baseline weight\u2009&gt;\u2009105 kg either died or had LV dysfunction at late follow up (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.001). Freedom from late valve-related complications at 5, 10, and 15 years was 72%, 31%, and 23%, respectively.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Preoperative LV dysfunction is associated with an increased risk of death for pediatric patients undergoing isolated rheumatic aortic valve surgery. This risk increases further, adjusting for BSA. There was a high rate of reoperations and late complications.\n                  <\/jats:p>","DOI":"10.1177\/21501351251339390","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T04:42:43Z","timestamp":1748320963000},"page":"94-105","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes After Surgery for Isolated Rheumatic Aortic Valve Disease in the Young: Preoperative Left Ventricular Dysfunction is a Risk Factor for Increased Mortality"],"prefix":"10.1177","volume":"17","author":[{"given":"Hilary A.","family":"Hardefeldt","sequence":"first","affiliation":[{"name":"Queensland Paediatric Cardiac Service, Queensland Children's Hospital, Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Kiyokawa","sequence":"additional","affiliation":[{"name":"Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Health New Zealand \u2013 Te Whatu Ora, Te Toka Tumai Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas L.","family":"Gentles","sequence":"additional","affiliation":[{"name":"Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Health New Zealand \u2013 Te Whatu Ora, Te Toka Tumai Auckland, Auckland, New Zealand"},{"name":"Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay J.","family":"Iyengar","sequence":"additional","affiliation":[{"name":"Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Health New Zealand \u2013 Te Whatu Ora, Te Toka Tumai Auckland, Auckland, New Zealand"},{"name":"The University of Auckland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan","family":"Mitchelson","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dug Yeo","family":"Han","sequence":"additional","affiliation":[{"name":"Starship Research and Innovation Office, Starship Children's Hospital, Health New Zealand \u2013 Te Whatu Ora, Te Toka Tumai Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsten","family":"Finucane","sequence":"additional","affiliation":[{"name":"Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Health New Zealand \u2013 Te Whatu Ora, Te Toka Tumai Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0551-4655","authenticated-orcid":false,"given":"Nigel J.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Health New Zealand \u2013 Te Whatu Ora, Te Toka Tumai Auckland, Auckland, New Zealand"},{"name":"The University of Auckland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"e_1_3_5_2_2","unstructured":"Institute for Health Metrics and Evaluation. 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