Long-term results of concomitant atrioventricular valve intervention and the Fontan operation. (4th February 2021)

• Record Type: Journal Article
• Authors: Yang, Yang; Feng, Zicong; Ma, Kai; Zhang, Sen; Zhang, Benqing; Qi, Lei; Wang, Guanxi; Li, Shoujun
• Is Part Of: European journal of cardio-thoracic surgery. Volume 59:Number 4(2021)
• Page Start: 832
• Page End: 838
• Publication Date: 2021-02-04
• Subjects: Fontan operation -- Atrioventricular valve regurgitation -- Fontan failure -- Valve failure; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; 617.54
• DOI: 10.1093/ejcts/ezaa464
• Languages: English
• ISSNs: 1010-7940

Abstract

Abstract: : OBJECTIVES: The optimal timing for atrioventricular valve (AVV) repair in patients with a Fontan circulation remains controversial. Few studies have reported the long-term outcomes of AVV repair concomitant with a Fontan operation. METHODS: From January 2006 to December 2018, a total of 89 patients who developed moderate or severe AVV regurgitation before a Fontan operation were divided into 2 groups: group 1, including 37 patients who did not undergo concomitant AVV repair; and group 2, including 52 patients who received AVV repair concomitant with a Fontan operation. RESULTS: The mean age at the time of the Fontan operation was 6.74 years for group 1 and 8.96 years for group 2, respectively. Early death occurred in 3 patients [2 patients (5.4%) in group 2, patient 1 (1.9%) in group 1]. Freedom from long-term death, cardiac function reduction and protein-losing enteropathy were similar among the 2 groups. Common AVV function was apparently poorer than mitral valve function after repair [hazard ratio (HR) 3.83, 95% confidence interval (CI) 1.31–11.17; P = 0.014]. The occurrence of AVV valve failure in group 1 was lower than that in group 2 (HR 0.44, 95% CI 0.22–0.91; P = 0.026). AVV function became worse during the follow-up period than that at discharge in both groups ( P = 0.03 in group 1 and P = 0.001 in group 2). CONCLUSIONS: The long-term results of AVV repair concomitant with a Fontan operation are favourable.