Predictors of Reintervention After Repair of Interrupted Aortic Arch With Ventricular Septal Defect

Primary Complete Repair of Interrupted Aortic Arch with Associated Lesions in Infants

“…Reintervention for subsequent LVOTO (range, 20% to 40%), often related to the development of a new and discrete subaortic membrane or valvar stenosis, is still required in a subset of IAA patients . Our retrospective study suggested that tailoring to the degree of subaortic narrowing, myectomy, and placement of the upper margin of the VSD patch on the left side of the conal septum were effective in preventing or prolonging the interval to recurrent LVOTO among the patients with severe LVOTO (3/23, 13%), favorably compared with the published data .…”

Preoperative echocardiographic measures in interrupted aortic arch: Which ones best predict surgical approach and outcome?

“…A recent study from Chen et al evaluated 70 patients with IAA that underwent primary repair and found that aortic root size was an independent predictor of subsequent LVOTO and that an aortic root size of 6.5 mm or less had the highest risk for requiring reintervention. Our study findings agree with those by Chen et al in that aortic root size is an independent risk factor for needing intervention for LVOTO following primary repair as well as for the need for reoperation in the entire group (primary and Yasui operation). In our study, the sinotubular junction size was also an independent risk factor for intervention for LVOTO among the primary repair group and reintervention in the entire group.…”

Growth of left ventricular outflow tract and predictors of future re-intervention after repair for ventricular septal defect and aortic arch obstruction

“…Considering this significant growth of the left ventricular outflow tract after surgical repair for aortic arch obstruction with ventricular septal defect, biventricular repair may be considered in patients even when the left ventricular outflow tract Z-score is significantly below normal. Many reports of small case series have tried to identify predictive risk factors associated with future left ventricular outflow tract obstruction after repair for ventricular septal defect and aortic arch obstruction coarctation or interrupted aortic archby using the following parameters: aortic root size < 6.5 mm, 15 small aortic valve with an annulus < 4.5 mm or Z-score less than −5, 16 indexed left ventricular outflow tract cross-sectional area < 0.7 cm 2 /m 2 , 7 small left ventricular outflow tract diameter, 8 left ventricular outflow tract-to-ascending aortic diameter ratio < 0.6, 17 and mitral valve Z-score less than −1. 18 None of the above-listed parameters, however, was associated with higher incidence of left ventricular outflow tract obstruction in our patients ( Table 2).…”