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

Published online by Cambridge University Press:  16 March 2017

Abdulraouf Jijeh Open the ORCID record for Abdulraouf Jijeh [Opens in a new window] ,
Muna Ismail  and
Fahad Alhabshan Open the ORCID record for Fahad Alhabshan [Opens in a new window]
Abdulraouf Jijeh
Affiliation:
King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard–Health Affairs, Riyadh, Kingdom of Saudi Arabia
Muna Ismail
Affiliation:
King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard–Health Affairs, Riyadh, Kingdom of Saudi Arabia
Fahad Alhabshan*
Affiliation:
King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard–Health Affairs, Riyadh, Kingdom of Saudi Arabia King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
*
Correspondence to: F. Alhabshan, MD, FESC, Consultant of Pediatric Cardiology, King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard–Health Affairs; Assistant Professor, Cardiac Sciences, King Saud Bin Abdulaziz University for Health Sciences, PO Box 22490, Mail Code 1420, Riyadh 11426, Kingdom of Saudi Arabia. Tel: +966 11 801 6770; Fax: +966 11 801 6773; E-mail: [email protected]
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Abstract

Ventricular septal defect and aortic arch obstruction are usually associated with a narrow left ventricular outflow tract. The aim of the present study was to analyse the growth and predictors of future obstruction of the left ventricular outflow tract after surgical repair.

Methods

We carried out a retrospective review of patients who underwent repair for ventricular septal defect and aortic arch obstruction – coarctation or interrupted aortic arch – between July, 2002 and June, 2013. Echocardiographic data were reviewed, and the need for re-intervention was evaluated.

Results

A total of 89 patients were included in this study. A significant left ventricular outflow tract growth was noticed after surgical repair. Preoperatively, the mean left ventricular outflow tract Z-score was −1.46±1 (range −5.5 to 1.1) and increased to a mean value of −0.7±1.3 (range −2.7 to 3.2) at last follow-up (p=0.0001), demonstrating relevant growth of the left ventricular outflow tract after repair for ventricular septal defect and aortic arch obstruction. After primary repair, 11 patients (12.3%) required re-intervention with surgical repair for left ventricular outflow tract obstruction after a mean period of 36±21 months. There were no significant differences in age, weight, and indexed aortic valve and left ventricular outflow tract measurements between those who developed obstruction and those who did not.

Conclusion

Significant left ventricular outflow tract growth is expected after repair of ventricular septal defect and aortic arch obstruction. Small aortic valve and left ventricular outflow tract at diagnosis are not risk factors to predict the need for surgical re-intervention for left ventricular outflow tract obstruction in future.

Keywords

ventricular septal defectcoarctation of the aortainterrupted aortic archleft ventricular outflow tract
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 7 , September 2017 , pp. 1323 - 1328
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Copyright
© Cambridge University Press 2017 

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Footnotes

*

Abdulraouf Jijeh and Muna Ismail contributed equally to this study.

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