Circulation, Vol 84, 2325-2335, Copyright © 1991 by American Heart Association
LA Rhodes, SD Colan, SB Perry, RA Jonas and SP Sanders
BACKGROUND. Failure of infants with critical aortic stenosis to survive
after adequate valvotomy despite a left ventricular size that appears to be
adequate indicates that additional preoperative anatomic features may
contribute to mortality. METHODS AND RESULTS. Discriminant analysis was
used to determine which of several echocardiographically measured left
heart structures were independent predictors of survival after valvotomy
for neonatal critical aortic stenosis. It was possible to predict outcome
after classic valvotomy (two-ventricle-type repair) with 95% accuracy based
on mitral valve area, long-axis dimension of the left ventricle relative to
the long-axis dimension of the heart, diameter of the aortic root, and body
surface area. Left ventricular volume was not a major determinant in this
study, in part because patients who had initial valvotomy had been
preselected in favor of an adequately sized left ventricle. Patients with
multiple small left ventricular structures were found to have significantly
improved survival after initial Norwood operation. In contrast, balloon
valvotomy with subsequent Norwood procedure was usually unsuccessful.
CONCLUSIONS. The adverse effects of small inflow, outflow, and/or cavity
size of the left ventricle are cumulative. The accuracy of prediction of
outcome based only on preoperative anatomy indicates that adequacy of
valvotomy is not generally a limiting factor for survival in this group of
patients. It is possible to identify subjects whose chance of survival is
better after a Norwood procedure rather than valvotomy, even if left
ventricular volume is not critically small.
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Predictors of survival in neonates with critical aortic stenosis [published erratum appears in Circulation 1995 Oct 1;92(7):2005]
Department of Cardiology, Children's Hospital, Boston, MA 02115.
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|
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|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
J. A. M. van Son, V. Falk, and F. W. Mohr Ross-Konno Operation With Resection of Endocardial Fibroelastosis for Critical Aortic Stenosis With Borderline-Sized Left Ventricle in Neonates Ann. Thorac. Surg., January 1, 1997; 63(1): 112 - 116. [Abstract] [Full Text]
|
|
|
|
|
|
S. F. Kaine, E. O'Brian Smith, A. R. Mott, C. E. Mullins, and T. Geva Quantitative Echocardiographic Analysis of the Aortic Arch Predicts Outcome of Balloon Angioplasty of Native Coarctation of the Aorta Circulation, September 1, 1996; 94(5): 1056 - 1062. [Abstract] [Full Text]
|
|
|
|
|
|
G. Sudow, L. Solymar, H. Berggren, B. Eriksson, D. Holmgren, and T. Gilljam AORTIC VALVE REPLACEMENT WITH A PULMONARY AUTOGRAFT IN INFANTS WITH CRITICAL AORTIC STENOSIS J. Thorac. Cardiovasc. Surg., August 1, 1996; 112(2): 433 - 436. [Abstract] [Full Text]
|
|
|
|
|
|
J. J. Lamberti The Aortic Valve: To Dilate, Repair, or Replace--That Is the Question Ann. Thorac. Surg., May 1, 1996; 61(5): 1297 - 1298. [Full Text]
|
|
|
|
|
|
L. K. Hornberger, S. P. Sanders, A. J.J.T. Rein, P. J. Spevak, I. A. Parness, and S. D. Colan Left Heart Obstructive Lesions and Left Ventricular Growth in the Midtrimester Fetus : A Longitudinal Study Circulation, September 15, 1995; 92(6): 1531 - 1538. [Abstract] [Full Text]
|
|
|
|
|
|
J. W. Gaynor, C. Bull, I. D. Sullivan, B. E. Armstrong, J. E. Deanfield, J. F. N. Taylor, P. G. Rees, R. M. Ungerleider, M. R. de Leval, J. Stark, et al. Late Outcome of Survivors of Intervention for Neonatal Aortic Valve Stenosis Ann. Thorac. Surg., July 1, 1995; 60(1): 122 - 125. [Abstract] [Full Text]
|
|
|
|
|
|
S. Conte, F. Lacour-Gayet, A. Serraf, M. Sousa-Uva, J. Bruniaux, A. Touchot, C. Planche, and S. b. A. Castaneda Surgical management of neonatal coarctation J. Thorac. Cardiovasc. Surg., April 1, 1995; 109(4): 663 - 675. [Abstract] [Full Text]
|
|
|
|
|
|
K. R. Kanter, B. E. Miller, A. G. Cuadrado, and R. N. Vincent Successful Application of the Norwood Procedure for Infants Without Hypoplastic Left Heart Syndrome Ann. Thorac. Surg., February 1, 1995; 59(2): 301 - 304. [Abstract] [Full Text]
|
|
|
|
|
|
R. A. Jonas, D. D. Hansen, N. Cook, and D. Wessel Anatomic subtype and survival after reconstructive operation for hypoplastic left heart syndrome J. Thorac. Cardiovasc. Surg., April 1, 1994; 107(4): 1121 - 1128. [Abstract] [Full Text]
|
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