PMID- 24563072
OWN - NLM
STAT- MEDLINE
DCOM- 20150410
LR  - 20211021
IS  - 1432-1971 (Electronic)
IS  - 0172-0643 (Print)
IS  - 0172-0643 (Linking)
VI  - 35
IP  - 6
DP  - 2014 Aug
TI  - Mixed aortic valve disease in the young: initial observations.
PG  - 934-42
LID - 10.1007/s00246-014-0878-6 [doi]
AB  - The short-term surgical results for mixed aortic valve disease (MAVD) and the 
      long-term effects on the left ventricle (LV) are unknown. Retrospective review 
      identified patients with at least both moderate aortic stenosis (AS) and aortic 
      regurgitation (AR) before surgical intervention. A one-to-one comparison cohort 
      of patients with MAVD not referred for surgical intervention was identified. The 
      45 patients in this study underwent surgical management for MAVD. A control group 
      of 45 medically managed patients with MAVD also was identified. Both groups had 
      elevated LV end-diastolic volume (EDV), elevated LV mass, a normal LV mass:volume 
      ratio (MVR), and a normal ejection fraction. Both groups had diastolic 
      dysfunction shown by early diastolic pulsed-Doppler mitral inflow/early diastolic 
      tissue Doppler velocity z-score. The LV end-diastolic pressure (EDP) was 
      correlated with age (R = 0.4; p = 0.03) and LV MVR (R = 0.4; p = 0.03) but not 
      with AS, AR, or the score combining gradient and LV size. As shown by 6- to 
      12-month postoperative echocardiograms, aortic valve gradients and AR 
      significantly improved (gradient 65 +/- 17 to 28 +/- 18 mmHg, p = 0.01; median 
      regurgitation grade moderate to mild; p < 0.01), LV EDV normalized, and LV mass 
      significantly improved (p < 0.01). Diastolic dysfunction was unchanged. Symptoms 
      did not correlate with any measured parameter, but the preoperative symptoms 
      resolved. In conclusion, despite diastolic dysfunction, systolic function is 
      invariably preserved, and symptoms are not correlated with aortic valve function 
      or LV EDP. Current surgical practice preserves LV mechanics and results in 
      short-term improvement in valve function and symptoms.
FAU - Hill, Allison C
AU  - Hill AC
AD  - Department of Cardiology, Boston Children's Hospital, 300 Longwood Avenue, 
      Boston, MA, 02115, USA.
FAU - Brown, David W
AU  - Brown DW
FAU - Colan, Steven D
AU  - Colan SD
FAU - Gauvreau, Kimberly
AU  - Gauvreau K
FAU - del Nido, Pedro J
AU  - del Nido PJ
FAU - Lock, James E
AU  - Lock JE
FAU - Rathod, Rahul H
AU  - Rathod RH
LA  - eng
GR  - T32 HL007572/HL/NHLBI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140222
PL  - United States
TA  - Pediatr Cardiol
JT  - Pediatric cardiology
JID - 8003849
SB  - IM
MH  - Adolescent
MH  - *Aortic Valve/diagnostic imaging/physiopathology/surgery
MH  - Bicuspid Aortic Valve Disease
MH  - Boston
MH  - Cardiac Catheterization/adverse effects/methods
MH  - *Cardiovascular Surgical Procedures/adverse effects/methods
MH  - Echocardiography, Doppler, Pulsed/methods
MH  - Female
MH  - Heart Defects, Congenital/diagnosis/physiopathology/*surgery
MH  - Heart Valve Diseases/diagnosis/physiopathology/*surgery
MH  - Heart Ventricles/pathology/physiopathology
MH  - Humans
MH  - Male
MH  - Organ Size
MH  - Outcome Assessment, Health Care
MH  - *Postoperative Complications/diagnosis/etiology/physiopathology
MH  - Retrospective Studies
MH  - Stroke Volume
MH  - Symptom Assessment/methods
MH  - Time Factors
MH  - *Ventricular Dysfunction, Left/diagnosis/etiology/physiopathology
PMC - PMC6951795
MID - NIHMS1066014
EDAT- 2014/02/25 06:00
MHDA- 2015/04/11 06:00
PMCR- 2020/01/09
CRDT- 2014/02/25 06:00
PHST- 2013/11/01 00:00 [received]
PHST- 2014/02/04 00:00 [accepted]
PHST- 2014/02/25 06:00 [entrez]
PHST- 2014/02/25 06:00 [pubmed]
PHST- 2015/04/11 06:00 [medline]
PHST- 2020/01/09 00:00 [pmc-release]
AID - 10.1007/s00246-014-0878-6 [doi]
PST - ppublish
SO  - Pediatr Cardiol. 2014 Aug;35(6):934-42. doi: 10.1007/s00246-014-0878-6. Epub 2014 
      Feb 22.