title: Surgical outcome of partial Shone complex.
abstract: Partial forms of Shone complex are rare. Surgical outcomes of the complete forms have generally been poor, whereas there is a lack of data on long-term follow-up of surgically treated adult partial complex. Between 2001 and 2011, nine patients (age: 38 ± 8 years; six males, 67%) were referred for valvular heart disease. Transthoracic and transoesophageal echocardiography was performed. Data were confirmed by intra-operative findings and reports. Patients were diagnosed as partial Shone complex and presented with mitral stenosis (MS) (45%) or mitral regurgitation (22%) or aortic regurgitation (22%). All but one patient (89%) reported previous surgery: coarctation of the aorta repair (87.5%) and aortic valvulotomy (12.5%). Redo intervention included: mitral valve replacement (25%), mitral repair (25%), aortic valve replacement (37.5%) and subvalvular aortic ridge resection (25%). One patient refused surgery. Patients surgically treated before the age of 5 (87.5%) showed favourable outcome (survival rate: 100%) and a 23.6 (± 4.6)-year follow-up free from events. The patient who underwent first intervention at the age of 50 and the patient with MS who refused surgery showed a 45 (± 7)-year follow-up free from major morbidity. Patients with partial Shone complex, properly diagnosed and treated, show favourable surgical outcome free from major clinical events.
authors.affiliation: Cardiovascular and Thoracic Department, San Raffaele Scientific Institute and Università Vita-Salute San Raffaele, Milan, Italy. antonio.grimaldi@hsr.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Grimaldi
authors.forename: Anna Chiara
authors.initials: AC
authors.lastname: Vermi
authors.forename: Siew Yen
authors.initials: SY
authors.lastname: Ho
authors.forename: Federico
authors.initials: F
authors.lastname: Pappalardo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Castiglioni
authors.forename: Stefano
authors.initials: S
authors.lastname: Benussi
authors.forename: Alberto
authors.initials: A
authors.lastname: Zangrillo
authors.forename: Ottavio
authors.initials: O
authors.lastname: Alfieri
mesh_terms: D000328:Adult; D001021:Aortic Valve / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D002675:Child, Preschool; D018572:Disease-Free Survival; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007223:Infant; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D011237:Predictive Value of Tests; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult