ニイナミ　ヒロシ   Niinami Hiroshi   新浪　博    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Late Neo-Aortic Valve Regurgitation Long After Arterial Switch Operation.
掲載誌名	正式名：The Annals of Thoracic Surgery 略　 称：Ann Thorac Surg ISSNコード：00034975/15526259
掲載区分	国外
出版社	Elsevier
巻・号・頁	108(4),pp.1210-1216
著者・共著者	NAKAYAMA Yuki†*, SHINKAWA Takeshi, MATSUMURA Goki, HOUKI Ryogo, KOBAYASHI Kei, NIINAMI Hiroshi
担当区分	最終著者
発行年月	2019/10
概要	BACKGROUND:The purpose of this study is to assess risk factors of neo-aortic regurgitation (AR) after an arterial switch operation and outcomes of neo-aortic valve surgery. METHODS:This is a retrospective study of 469 hospital survivors after arterial switch operation from 1982 to 2016. Preoperative diagnoses included 285 transpositions of the great arteries with intact septum, 140 transpositions with ventricular septal defect, and 44 double-outlet right ventricles. More than mild preoperative pulmonary regurgitation was found in 15 patients. Median age at the operation was 1.0 months (range, 0.1-81.5). Concomitant relief of left ventricular outflow tract obstruction was performed in 20 patients. Seventy-seven patients had more than mild neo-AR at hospital discharge. RESULTS:More than moderate neo-AR was found in 41 patients (8.6%) at a median follow-up of 19.0 years (range, 0.1-35.2). Multivariate analysis identified more than mild preoperative pulmonary regurgitation, concomitant relief of left ventricular outflow tract obstruction, and more than mild neo-AR at hospital discharge as risk factors for late neo-AR. Seventeen patients (3.6%) underwent neo-aortic valve surgeries, including 11 aortic valve replacements, 3 aortic valve plasties, 2 Konno procedures, and 1 aortic root replacement, with median age at the neo-aortic valve surgery of 16.5 years (range, 6.2-27.3). There were 2 late deaths and 5 reoperations to the neo-aortic valve in 4 patients. CONCLUSIONS:Concomitant relief of left ventricular outflow tract obstruction and preoperative more than mild pulmonary regurgitation increase the risk of neo-AR after the arterial switch operation. Reoperation for neo-AR can be done safely.
DOI	10.1016/j.athoracsur.2019.04.009
PMID	31077656