Abstract
Objective. Analysis of all outcomes is required to determine the features of this technique in children depending on age.
Material and methods. Ozaki method was used for surgical treatment of congenital bicuspid aortic valve (BAV) disease either at the pre-school/school age (group 1, n=15) or adolescence (group 2, n=13). Data were retrospectively studied since the OP had been applied from 2017 to 2021.
Results. The median age at surgery was 8 (4--9) years in group 1 and 15 (14--17) years in group 1 (p=0.001). Four patients had prior balloon dilation of the aortic valve in group 1 versus one in group 2 (p=0.01). Seven (25%) patients had concomitant aortic arch repair (all in group 2, p=0,005). In group 2, the dilation of the ascending aorta correlated with the body surface area (BSA) (r=0.63). The ratio of the value of the sizers' sums to a patient's BSA was statistically significant difference in favor of larger values for group 1 (p=0.001). A statistically significant correlation of the average sizer size and their sum with the BSA was found only in group 2 (r=0.56, p=0.04) The freedom from reoperations was 100%.
Conclusion. Apparently, aortic root changes with dilatation of the ascending aorta develop its starting from early preschool age. Performing neo-cuspidization gave a possibility to achieve stable dimensions of the ascending aorta during follow-up. However, OP in children requires a long-term follow-up study to address the optimal surgical strategy.
References
- Bockeria L.A., Shatalov K.V. (Eds.) Pediatric cardiac surgery: A Guide for physicians. Moscow; 2016 (in Russ.).
- Podzolkov V.P., Samsonov V.B., Mataev V.S., Chiaureli M.R., Gadzhieva A.Sh., Danilov T.Yu. et al. Mid-term results of open valvulotomy for congenital aortic valve stenosis. The Bulletin of Bakoulev Center for Cardiovascular Diseases. 2018; 19 (3): 338–42 (in Russ.). DOI: 10.24022/1810-0694-2018- 19-3-338-342
- Lambert V., Obreja D., Losay J., Touchot-Kone′ A., Piot J.D., Serraf A., Lacour-Gayet F., Planche C. Long-term results after valvotomy for congenital aortic valvar stenosis in children. Cardiol. Young. 2000; 10 (6): 590-6. DOI: 10.1017/s1047951100008866
- Presbitero P., Somerville J., Revel-Chion R., Ross D. Open aortic valvotomy for congenital aortic stenosis. Late results. Br. Heart J. 1982; 47 (1): 26–34. DOI: 10.1136/hrt.47.1.26
- Chernogrivov A., Bofanov D., Chernogrivov I., Sulejmanov Sh., Rybakova T., Nazarova I., Bazylev V. Open surgery for bicuspid aortic valve in neonates and infants: what should we know about the anatomy? Abstracts of the joint meeting of the European Congenital Heart Surgeons Association and the World Society for Pediatric and Congenital Heart Surgery, Sofia, Bulgaria, June 20 to 22, 2019. World J. Pediatr. Congenit. Heart Surg. 2019; 10 (6): NP1–38. DOI: 10.1177/2150135119869003
- Mimic B., Wiggins L., Bonello B., Marek J., Ilic S., Kostolny M. Promising short term outcomes of aortic valve neo-tricuspidalization in children and young adults. Abstracts of the joint meeting of the European Congenital Heart Surgeons Association and the World Society for Pediatric and Congenital Heart Surgery, Sofia, Bulgaria, June 20 to 22, 2019. World J. Pediatr. Congenit. Heart Surg. 2019; 10 (6): NP1–38. DOI: 10.1177/2150135119869003
- Ozaki S., Kawase I., Yamashita H., Uchida S., Takatoh M., Kiyohara N. Midterm outcomes after aortic valve neocuspidization with glutaraldehyde-treated autologous pericardium. J. Thorac. Cardiovasc. Surg. 2018; 155 (6): 2379–87. DOI: 10.1016/j.jtcvs.2018.01.087
- Rosseykin E.V., Kobzev E.E., Bazylev V.V. Operation Ozaki from mini-access. Angiology and Vascular Surgery. 2019; 25 (3): 142–8 (in Russ.). DOI: 10.33529/ANGIO2019319
- Bazylev V.V., Rosseykin E.V., Babukov R.M., Mikulyak A.I., Bartosh F.L., Slastin Ya.S. Comparison of early and midterm results in patients with a narrow aortic root after aortic valve replacement using a biological prosthesis with aortic root enlargement and aortic leaflets replacement with autologous pericardium (Ozaki procedure). Clinical and Experimental Surgery. Petrovsky Journal. 2019; 7 (1): 34–43 (in Russ.). DOI: 10.24411/2308-1198-2019-11005
- Nishimura R.A., Otto C.M., Bonow R.O., Carabello B.A., Erwin J.P. 3rd, Fleisher L.A. et al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American HeartAssociation Task Force on Clinical Practice Guidelines. J. Am. Coll. Cardiol. 2017; 70 (2): 252–89. DOI: 10.1016/j.jacc. 2017.03.011
- Z-score calculator. Boston Children's Hospital. https://zscore.chboston.org/(дата обращения 28.05.2021 /accessed May 28, 2021).
- Ozaki S., Kawase I., Yamashita H., Uchida S., Takatoh M., Kiyohara N. A total of 404 cases of aortic valve reconstruction with glutaraldehyde-treated autologous pericardium. J. Thorac. Cardiovasc. Surg. 2014; 147 (1): 301–6. DOI: 10.1016/j.jtcvs.2012.11.012
- Kim A.I., Rogova T.V., Grigor'yants T.R., Netalieva G.S. Correction of anomalous left coronary artery from nonfacing pulmonary sinus in underweight infant. Children's Heart and Vascular Diseases. 2018; 15 (3): 165–8 (in Russ.). DOI: 10.24022/1810-0686-2018-15-3-165-168
- Elisabeth M., Laurin C., Jacques F., Houde C., Cote J-M., Chetaille Ph. et al. More than 25 years of experience with the Ross procedure in children: a single-center experience. Ann. Thorac. Surg. 2020; 110 (2); 638–44. DOI: 10.1016/j.athoracsur.2019.10.093
- Luciani G.B., Lucchese G., Carotti A., Brancaccio G., Abbruzzese P., Caianiello G. et al. Two decades of experience with the Ross operation in neonates, infants and children from the Italian Paediatric Ross Registry. Heart. 2014; 100 (24): 1954–9. DOI: 10.1136/heartjnl-2014-305873
- Nordmeyer S., Murin P., Schulz A., Danne F., Nordmeyer J., Kretzschmar J. et al. Results of aortic valve repair using decellularized bovine pericardium in congenital surgery. Eur. J. Cardiothorac. Surg. 2018; 54 (6): 986–92. DOI: 10.1093/ejcts/ezy181
- Vergnat M., Asfour B., Arenz C., Suchowerskyj P., Bierbach B., Schindler E. et al. Aortic stenosis of the neonate: a single-center experience. J. Thorac. Cardiovasc. Surg. 2019; 157 (1): 318–26.e1. DOI: 10.1016/j.jtcvs.2018.08.089
- Mathieu P., Bosse′ Y., Huggins G.S., Della Corte A., Pibarot P., Michelena H.I. et al. The pathology and pathobiology of bicuspid aortic valve: State of the art and novel research perspectives. J. Pathol. Clin. Res. 2015; 1 (4): 195–206. DOI: 10.1002/cjp2.21
- Della Corte A., Bancone C., Dialetto G., Covino F.E., Manduca S., Montibello M.V. et al. The ascending aorta with bicuspid aortic valve: a phenotypic classification with potential prognostic significance. Eur. J. Cardiothorac. Surg. 2014; 46 (2): 240–7; discussion 247. DOI: 10.1093/ejcts/ezt621. 2014; 45 (4): e118–24; discussion e124. DOI: 10.1093/ejcts/ezt601
- Della Corte A., Bancone C., Quarto C., Dialetto G., Covino F.E., Scardone M. et al. Predictors of ascending aortic dilatation with bicuspid aortic valve: a wide spectrum of disease expression. Eur. J. Cardiothorac. Surg. 2007; 31 (3): 397–404; discussion 404–5. DOI: 10.1016/j.ejcts.2006.12.006
- Guzzardi D.G., Barker A.J., van Ooij P., Malaisrie S.C., Puthumana J.J., Belke D.D. et al. Valve-related hemodynamics mediate human bicuspid aortopathy: insights from wall shear stress mapping. J. Am. Coll. Cardiol. 2015; 66 (8): 892–900. DOI: 10.1016/j.jacc.2015.06.1310
- Yamamoto Y., Iino K., Shintani Y., Kato H., Keiichi K., Watanabe G., Takemura H. Comparison of aortic annulus dimension after aortic valve neocuspidization with valve replacement and normal valve. Semin. Thorac. Cardiovasc. Surg. 2017; 29 (2): 143–9. DOI: 10.1053/j.semtcvs.2016.11.002
- Kim M.S., Kim J.H., Lee S.H., Lee S., Youn Y.N., Yoo K.J., Joo H.C. Long-term fate of dilated ascending aorta after aortic valve replacement for bicuspid versus tricuspid aortic valve disease. Am. J. Cardiol. 2020; 129: 53–9. DOI: 10.1016/j.amjcard.2020.05.026
- Bilkhu R., Youssefi P., Soppa G., Theodoropoulos P., Phillips S., Liban B. et al. Fate of the aortic arch following surgery on the aortic root and ascending aorta in bicuspid aortic valve. Ann. Thorac. Surg. 2018; 106 (3): 771–6. DOI: 10.1016/j.athoracsur.2018.03.052
- Charitos E.I., Stierle U., Petersen M., Mohamed S.A., Hanke T., Schmidtke C. et al. The fate of the bicuspid valve aortopathy after aortic valve replacement. Eur. J. Cardiothorac. Surg. 2014; 45 (5): e128–35. DOI: 10.1093/ejcts/ezt666
- Wiggins L.M., Mimic B., Issitt R., Ilich S., Bonello B., Marek Y. et al. The utility of aortic valve leaflet reconstruction techniques in children and young adults. J. Thorac. Cardiovasc. Surg. 2020; 159 (6): 2369–78. DOI: 10.1016/j.jtcvs.2019.09.176
- Sievers H.H., Schmidtke C. A classification system for the bicuspid aortic valve from 304 surgical specimens. J. Thorac. Cardiovasc. Surg. 2007; 133 (5): 1226–33. DOI: 10.1016/j.jtcvs.2007.01.039
- Krane M., Boehm J., Prinzing A., Ziegelmu¨ller J., Holfeld J., Lange R. Excellent hemodynamic performance after aortic valve neocuspidization (AVNeo) using autologous pericardium [published online ahead of print, 2020 Jun 12]. Ann. Thorac. Surg. 2021; 111 (1): 126–33. DOI: 10.1016/j.athoracsur.2020.04.108
- Konstantinov I.E., Naimo P.S., Buratto E. Commentary: Ozaki valve reconstruction in children: Is it still a valve replacement? J. Thorac. Cardiovasc. Surg. 2021; 161 (5): 1579–81. DOI: 10.1016/j.jtcvs.2020.02.030
- Karamlou T., Pettersson G., Nigro J.J. Commentary: A pediatric perspective on the Ozaki procedure. J. Thorac. Cardiovasc. Surg. 2021; 161 (5): 1582–3. DOI: 10.1016/j.jtcvs.2020.02.128
About the authors
- Vladlen V. Bazylev, Dr. Med. Sci., Professor, Chief Physician; ORCID
- Igor’ E. Chernogrivov, Dr. Med. Sci., Cardiovascular Surgeon; ORCID
- Dmitriy A. Bofanov, Cardiovascular Surgeon; ORCID
- Ruslan M. Babukov, Ultrasonic Diagnostics Physician; ORCID
- Alishir B. Gamzaev, Dr. Med. Sci., Professor; ORCID
- Bachuki R. Nachkebiya, Cardiovascular Surgeon; ORCID
- Tat’yana V. Rybakova, Pediatric Cardiologist; ORCID
- Aleksey E. Chernogrivov, Dr. Med. Sci., Professor, Head of Department;ORCID
