title: Valve-sparing root replacement in children.
abstract: OBJECTIVE
  In children, words of caution have been raised about valve-sparing procedures especially regarding the valve-remodelling technique. This study reviewed our experience with the valve-sparing reimplantation technique in children.
  
  
  METHODS
  All consecutive paediatric (<18 years) patients who underwent valve-sparing root replacement in our centre in the past 12.5 years were retrospectively analysed.
  
  
  RESULTS
  Nineteen patients (median age 13.2 years, 10 months to 17.9 years) underwent valve-sparing root replacement using the reimplantation technique. Seventeen had connective tissue disease. An adult-sized vascular prosthesis could be implanted in all cases. Additional cusp repair was required in 3 patients. Follow-up was 4.4 ± 3.8 years. There was no perioperative mortality and one late death. Of the 3 patients that needed cusp repair, 1 developed Grade 3 aortic valve regurgitation (AR) and required aortic valve replacement and 2 had Grade 1 AR. Ninety-four percent of the other patients had Grade 0 AR at latest follow-up, 1 patient (6%) had Grade 1 AR.
  
  
  CONCLUSIONS
  Our data show that valve-sparing root surgery using the reimplantation technique can be performed safely in children. Mid-term follow-up yields stable and favourable results. When leaflet reconstruction is necessary on top of the reimplantation procedure, rate of recurrent AR seems to be higher.
authors.affiliation: Department of Cardiothoracic Surgery, Leiden University Center, Leiden, Netherlands Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, Netherlands.
authors.forename: Jolanda
authors.initials: J
authors.lastname: Kluin
authors.affiliation: Department of Cardiothoracic Surgery, Leiden University Center, Leiden, Netherlands Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, Netherlands.
authors.forename: David R
authors.initials: DR
authors.lastname: Koolbergen
authors.affiliation: Department of Cardiothoracic Surgery, Leiden University Center, Leiden, Netherlands Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, Netherlands.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Sojak
authors.affiliation: Department of Cardiothoracic Surgery, Leiden University Center, Leiden, Netherlands Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, Netherlands m.g.hazekamp@lumc.nl.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Hazekamp
mesh_terms: D000293:Adolescent; D001011:Aorta / Q000000981:diagnostic imaging / Q000601:surgery*; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D008382:Marfan Syndrome / Q000000981:diagnostic imaging / Q000601:surgery; D011474:Prosthesis Design; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Aortic valve preservation; Aortic valve repair; Children; Congenital; Paediatric; Valve-sparing root replacement