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Authors: V.B. Samsonov, V.S. Mataev, V.P. Podzolkov

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

Heading: Original Research

UDC: 616.126.52-053.5/.7-089.844

Link: Clinical Physiology of Blood Circulaiton. 2018; 2 (1): 5-9

Quote as: Samsonov V.B., Mataev V.S., Mataev V.S. Comparative results of aortic valve replacement with and without Manouguian technic in adolescents with «normal» aortic annulus. Novosti Serdechno-Sosudistoy Khirurgii (Cardiovascular Surgery News). 2018; 2 (1): 5–9 (in Russ.).

Received / Accepted:  01.02.2018/13.02.2018

Full text:  


Abstract

The objective is to present the immediate and mid-term results of aortic valve replacement with the Manouguian technique for without it adolescents with a «normal» aortic annulus.

Material and methods. 25 children aged 10–15 years underwent conventional aortic valve replacement (12 cases) and with Manouguian technic used (13 cases) (groups 1&2). Mean age was 13,0±1,4 and 12,4±1,3 years (р=0,3). Average value of aortic valve annular diameter was 22±1,5 and 20±2,2 мм (р=0,07). There were no aortic annulus hypoplasia in both groups (median Z-score 2 (1–3) and 1 (1–3) (p=0,2)). Underlying pathology in both groups was valvular aortic stenosis with median peak gradient of 58 (44–97) and 80 (72–92) mm Hg (p=0,1). All surgery had being performed in moderate hypothermia. Mechanical valves where used in all patients.

Results. No significant difference had being observed on such variables as implanted valve diameter, in-hospital stay and left ventricle ejection fraction. There was no in-hospital or late deaths. Follow-up was complete in 100% cases; median time was 3,7±2,6 and 3,6±2,2 years (p=0,6). We have observed significant increase of mitral valve insufficiency in the 2nd group – 4 patients developed mild MVR, and 2 patients developed severe MVR, requiring valve replacement in 1 case. Reoperation frequency was also different (but not statistically significant) in both groups: in the 1st group only 2 patients required valve replacement, with cumulative freedom 83,3% versus 5 patients and cumulative freedom of 61,5% in the 2nd group. Factors associated with reoperation where infective endocarditis in 1st group and progressive ascending aorta dilation in 2nd.

Conclusion. Both, conventional aortic valve replacement and aortic root enlargement with Manouguian technic in adolescents with non-hypoplastic aortic annulus demonstrate acceptable immediate and mid-term results. Conventional aortic valve replacement should be favored due to less ischemic time and complication frequency.

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About Authors

  • Samsonov Viktor Borisovich, Dr. Med. Sc., Leading Researcher, orcid.org/0000-0002-6477-7914;
  • Mataev Viktor Sergeevich, Cand. Med. Sc., Leading Researcher, orcid.org/0000-0003-4386-1233;
  • Podzolkov Vladimir Petrovich, Dr. Med. Sc., Professor, Chief of Department, orcid.org/0000-0002-2863-2072

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