{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:12:10Z","timestamp":1753891930060,"version":"3.41.2"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T00:00:00Z","timestamp":1731974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>In the congenital population, particularly in young adults, the best strategy for aortic valve surgery has not been clearly established. This study investigates the mortality, perioperative morbidity and echocardiographic evolution of complex aortic valve repair techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We performed a retrospective monocentric descriptive study of patients operated at the Louis Pradel Hospital (Lyon) from 2017 to 2023. We included patients operated for complex aortic valve repair by the congenital heart surgery team, excluding simple commissurotomies. The primary endpoint was postoperative survival. The secondary endpoints were freedom from surgical reintervention and echocardiographic evolution of aortic regurgitation, aortic stenosis and annular diameter. The analysis was performed using Kaplan Meier methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-eight patients were included. The mean age was 11.1 years (range 1\u201335 years) and the mean weight was 37.5\u2005kg (range 8.2\u201379\u2005kg). The postoperative survival rate was 96.4% at discharge (27\/28 patients). The mean follow-up interval was 35 months (range 14\u201379 months). At the end of the follow-up, the freedom from reoperation was 85.7%. Four patients underwent reoperation for worsening aortic valve and\/or ventricular function (1 heart transplantation, 2 Ross procedures, 1 aortic valve replacement). Results on secondary endpoints showed a trend towards improvement in annular diameter postoperatively between pre- and postoperative echocardiography for each patient, with no statistically significant difference for aortic insufficiency, but for aortic stenosis (<jats:italic>p<\/jats:italic>\u2009=\u20090.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study shows an excellent survival rate, and a similar risk of reintervention compared with literature data. All the data described above argue in favor of an aortic valve repair surgery as a first line procedure in case of congenital heart disease.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1466311","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T16:28:27Z","timestamp":1732033707000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Complex aortic valve repair in congenital patients: clinical feedback"],"prefix":"10.3389","volume":"12","author":[{"given":"Marie-Anne","family":"Barbier","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolae Cristian","family":"Bulescu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Metton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lea","family":"Bou Karam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Martin Bonnet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Moulin Zinsch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Lilot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Henaine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1053\/j.semtcvs.2019.05.033","article-title":"Aortic valve surgery in nonelderly patients: insights gained from AVIATOR","volume":"31","author":"Lansac","year":"2019","journal-title":"Semin Thorac Cardiovasc Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"10","DOI":"10.12945\/j.aorta.2014.14-003","article-title":"Aortic valve repair: a systematic review and meta-analysis of published literature","volume":"2","author":"Fok","year":"2014","journal-title":"AORTA"},{"key":"B3","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1016\/j.ejcts.2007.12.033","article-title":"A lesional classification to standardize surgical management of aortic insufficiency towards valve repair\u22c6","volume":"33","author":"Lansac","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"article-title":"An\u00e9vrismes de l\u2019aorte ascendante, bicuspidies, insuffisance aortique: de l\u2019analyse \u00e9chographique \u00e0 la chirurgie r\u00e9paratrice de la valve aortique \u2013 Ascending aorta aneurysms, bicuspid valve, aortic insufficiency: from echographic analysis to aortic valve repair. MISE AU POINT. 7","year":"","author":"Lansac","key":"B4"},{"key":"B5","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1093\/ejcts\/ezu174","article-title":"An expansible aortic ring to preserve aortic root dynamics after aortic valve repair\u2020","volume":"47","author":"Wuliya","year":"2015","journal-title":"Eur J Cardiothorac Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.1136\/hrt.2009.190520","article-title":"Aortic valve surgery in children","volume":"97","author":"d\u2019Udekem","year":"2011","journal-title":"Heart"},{"key":"B7","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1093\/ejcts\/ezu058","article-title":"Aortic valve repair with patch in non-rheumatic disease: indication, techniques and durability\u2020","volume":"46","author":"Nezhad","year":"2014","journal-title":"Eur J Cardio-Thorac Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1053\/j.pcsu.2017.11.009","article-title":"Aortic valvuloplasty or rootplasty for aortic regurgitation","volume":"21","author":"ElZein","year":"2018","journal-title":"Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu"},{"key":"B9","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1016\/j.jtcvs.2020.08.116","article-title":"Valve-sparing aortic root surgery in children and adults with congenital heart disease","volume":"162","author":"Buratto","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.ejcts.2010.01.041","article-title":"An aortic ring to standardise aortic valve repair: preliminary results of a prospective multicentric cohort of 144 patients\u22c6","volume":"38","author":"Lansac","year":"2010","journal-title":"Eur J Cardiothorac Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2873","DOI":"10.1093\/eurheartj\/ehu281","article-title":"2014 ESC guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult","volume":"35","year":"2014","journal-title":"Eur Heart J"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1527","DOI":"10.1016\/j.athoracsur.2009.06.036","article-title":"Current surgical management of ascending aortic aneurysm in children and young adults","volume":"88","author":"Ono","year":"2009","journal-title":"Ann Thorac Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1180","DOI":"10.1016\/j.jtcvs.2021.02.093","article-title":"Ross procedure or complex aortic valve repair using pericardium in children: a real dilemma","volume":"163","author":"Danial","year":"2022","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1016\/j.jtcvs.2020.06.145","article-title":"Aortic valve surgery in children","volume":"161","author":"Buratto","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1111\/jocs.14032","article-title":"Aortic valve repair or replacement in patients with aortic regurgitation: a systematic review and meta-analysis","volume":"34","author":"Wong","year":"2019","journal-title":"J Card Surg"},{"key":"B16","doi-asserted-by":"publisher","first-page":"ehab395","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 ESC\/EACTS guidelines for the management of valvular heart disease","volume":"43","author":"Vahanian","year":"2021","journal-title":"Eur Heart J"},{"key":"B17","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1053\/j.jvca.2011.07.014","article-title":"Aortic valve repair for aortic insufficiency: a review","volume":"26","author":"Prodromo","year":"2012","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"B18","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1053\/j.pcsu.2014.01.006","article-title":"Reoperations for pediatric and congenital heart disease: an analysis of the society of thoracic surgeons (STS) congenital heart surgery database","volume":"17","author":"Jacobs","year":"2014","journal-title":"Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu"},{"key":"B19","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.ejcts.2009.06.021","article-title":"Aortic valve repair leads to a low incidence of valve-related complications","volume":"37","author":"Aicher","year":"2010","journal-title":"Eur J Cardiothorac Surg"},{"key":"B20","doi-asserted-by":"publisher","first-page":"2202","DOI":"10.1016\/j.jtcvs.2018.10.076","article-title":"AVIATOR: an open international registry to evaluate medical and surgical outcomes of aortic valve insufficiency and ascending aorta aneurysm","volume":"157","author":"de Heer","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"420","DOI":"10.21037\/acs-2020-rp-23","article-title":"The ross procedure in children: a systematic review","volume":"10","author":"Moroi","year":"2021","journal-title":"Ann Cardiothorac Surg"},{"key":"B22","doi-asserted-by":"publisher","first-page":"2369","DOI":"10.1016\/j.jtcvs.2019.09.176","article-title":"The utility of aortic valve leaflet reconstruction techniques in children and young adults","volume":"159","author":"Wiggins","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1016\/j.athoracsur.2016.06.072","article-title":"Suture annuloplasty significantly improves the durability of bicuspid aortic valve repair","volume":"103","author":"Schneider","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1366","DOI":"10.1001\/jamacardio.2020.3749","article-title":"Long-term results of differentiated anatomic reconstruction of bicuspid aortic valves","volume":"5","author":"Schneider","year":"2020","journal-title":"JAMA Cardiol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1016\/j.athoracsur.2019.09.019","article-title":"Concepts of bicuspid aortic valve repair: a review","volume":"109","author":"Ram","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"B26","doi-asserted-by":"publisher","first-page":"S234","DOI":"10.1016\/j.cjca.2016.07.376","article-title":"Cusp interventions in aortic valve repair: are all pericardial patches created equally?","volume":"32","author":"Ngu","year":"2016","journal-title":"Can J Cardiol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1093\/icvts\/ivx295","article-title":"Initial 2-year results of CardioCel\u00ae patch implantation in children","volume":"26","author":"Pavy","year":"2018","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B28","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1053\/j.semtcvs.2018.10.009","article-title":"Aortic valve interventions in pediatric patients","volume":"31","author":"Bouhout","year":"2019","journal-title":"Semin Thorac Cardiovasc Surg"},{"key":"B29","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.jtcvs.2008.08.054","article-title":"Repair-oriented classification of aortic insufficiency: impact on surgical techniques and clinical outcomes","volume":"137","author":"Boodhwani","year":"2009","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B30","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1007\/s11886-014-0490-7","article-title":"Aortic valve repair: indications and outcomes","volume":"16","author":"Boodhwani","year":"2014","journal-title":"Curr Cardiol Rep"},{"key":"B31","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.jtcvs.2022.10.017","article-title":"Aortic valve repair using geometric ring annuloplasty in pediatric and congenital heart disease patients","volume":"166","author":"Lancaster","year":"2023","journal-title":"Journal Thorac and Cardiovasc Surg"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1466311\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T16:28:30Z","timestamp":1732033710000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1466311\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,19]]},"references-count":31,"alternative-id":["10.3389\/fped.2024.1466311"],"URL":"https:\/\/doi.org\/10.3389\/fped.2024.1466311","relation":{},"ISSN":["2296-2360"],"issn-type":[{"type":"electronic","value":"2296-2360"}],"subject":[],"published":{"date-parts":[[2024,11,19]]},"article-number":"1466311"}}