Skip to main content
Erschienen in: Pediatric Cardiology 8/2014

01.12.2014 | Review Article

Timing of Aortic Valve Intervention in Pediatric Chronic Aortic Insufficiency

verfasst von: Justin T. Tretter, Alan Langsner

Erschienen in: Pediatric Cardiology | Ausgabe 8/2014

Einloggen, um Zugang zu erhalten

Abstract

The timing of aortic valve intervention (AVI) in pediatric patients with chronic aortic insufficiency (AI) is largely based on adult experience, which is fraught with uncertainty and controversy. Current adult guidelines in the absence of symptoms use left ventricular (LV) systolic function and LV dimensions to guide AVI timing, with few studies translating these recommendations to pediatric patients. This article reviews the current guidelines for AVI timing in chronic AI along with the emerging data for pediatric patients.
Literatur
1.
Zurück zum Zitat Alsoufi B, Al-Halees Z, Manlhiot C et al (2009) Mechanical valves versus the Ross procedure for aortic valve replacement in children: propensity-adjusted comparison of long-term outcomes. J Thorac Cardiovasc Surg 137:362–370CrossRefPubMed Alsoufi B, Al-Halees Z, Manlhiot C et al (2009) Mechanical valves versus the Ross procedure for aortic valve replacement in children: propensity-adjusted comparison of long-term outcomes. J Thorac Cardiovasc Surg 137:362–370CrossRefPubMed
2.
Zurück zum Zitat Bonow RO (2011) Aortic regurgitation: time to reassess timing of valve replacement? JACC Cardiovasc Imaging 4:223–230CrossRef Bonow RO (2011) Aortic regurgitation: time to reassess timing of valve replacement? JACC Cardiovasc Imaging 4:223–230CrossRef
3.
Zurück zum Zitat Bonow RO, Rosing DR, McIntosh CL et al (1983) The natural history of asymptomatic patients with aortic regurgitation and normal left ventricular function. Circulation 68:509–517CrossRefPubMed Bonow RO, Rosing DR, McIntosh CL et al (1983) The natural history of asymptomatic patients with aortic regurgitation and normal left ventricular function. Circulation 68:509–517CrossRefPubMed
4.
Zurück zum Zitat Bonow RO, Lakatos E, Maron BJ, Epstein SE (1991) Serial long-term assessment of the natural history of asymptomatic patients with chronic aortic regurgitation and normal left ventricular systolic function. Circulation 84:1625–1635CrossRefPubMed Bonow RO, Lakatos E, Maron BJ, Epstein SE (1991) Serial long-term assessment of the natural history of asymptomatic patients with chronic aortic regurgitation and normal left ventricular systolic function. Circulation 84:1625–1635CrossRefPubMed
5.
Zurück zum Zitat Borer JS, Hochreiter C, Herrold EM, Supino P, Aschermann M, Wencker D, Devereux RB, Roman MJ, Szulc M, Kligfield P, Isom OW (1998) Prediction of indications for valve replacement among asymptomatic or minimally symptomatic patients with chronic aortic regurgitation and normal left ventricular performance. Circulation 97:525–534PubMedCentralCrossRefPubMed Borer JS, Hochreiter C, Herrold EM, Supino P, Aschermann M, Wencker D, Devereux RB, Roman MJ, Szulc M, Kligfield P, Isom OW (1998) Prediction of indications for valve replacement among asymptomatic or minimally symptomatic patients with chronic aortic regurgitation and normal left ventricular performance. Circulation 97:525–534PubMedCentralCrossRefPubMed
6.
Zurück zum Zitat Brown ML, Schaff HV, Suri RM et al (2009) Indexed left ventricular dimensions best predict survival after aortic valve replacement in patients with aortic valve regurgitation. Ann Thorac Surg 87:1170–1175CrossRefPubMed Brown ML, Schaff HV, Suri RM et al (2009) Indexed left ventricular dimensions best predict survival after aortic valve replacement in patients with aortic valve regurgitation. Ann Thorac Surg 87:1170–1175CrossRefPubMed
7.
Zurück zum Zitat Buddhe S, Du W, Walters HL, Delius R, Pettersen MD (2013) Predictors of left ventricular remodeling after aortic valve replacement in pediatric patients with isolated aortic regurgitation. Congenit Heart Dis 8:167–173CrossRefPubMed Buddhe S, Du W, Walters HL, Delius R, Pettersen MD (2013) Predictors of left ventricular remodeling after aortic valve replacement in pediatric patients with isolated aortic regurgitation. Congenit Heart Dis 8:167–173CrossRefPubMed
8.
Zurück zum Zitat Cohn PF, Gorlin R, Cohn LH, Collins JJ (1974) Left ventricular ejection fraction as a prognostic guide in surgical treatment of coronary and valvular heart disease. Am J Cardiol 34:136–141CrossRefPubMed Cohn PF, Gorlin R, Cohn LH, Collins JJ (1974) Left ventricular ejection fraction as a prognostic guide in surgical treatment of coronary and valvular heart disease. Am J Cardiol 34:136–141CrossRefPubMed
9.
Zurück zum Zitat Di Salvo G, Rea A, Mormile A et al (2012) Usefulness of bidimensional strain imaging for predicting outcome in asymptomatic patients aged ≤16 years with isolated moderate to severe aortic regurgitation. Am J Cardiol 110:1051–1055CrossRefPubMed Di Salvo G, Rea A, Mormile A et al (2012) Usefulness of bidimensional strain imaging for predicting outcome in asymptomatic patients aged ≤16 years with isolated moderate to severe aortic regurgitation. Am J Cardiol 110:1051–1055CrossRefPubMed
10.
Zurück zum Zitat Donofrio MT, Engle MA, O’Loughlin JE, Snyder MS, Levin AR, Ehlers KH, Gold J (1992) Congenital aortic regurgitation: natural history and management. J Am Coll Cardiol 20:366–372CrossRefPubMed Donofrio MT, Engle MA, O’Loughlin JE, Snyder MS, Levin AR, Ehlers KH, Gold J (1992) Congenital aortic regurgitation: natural history and management. J Am Coll Cardiol 20:366–372CrossRefPubMed
11.
Zurück zum Zitat Dulce MC, Mostbeck GH, O’Sullivan M, Cheitlin M, Caputo GR, Higgins CB (1992) Severity of aortic regurgitation: interstudy reproducibility of measurements with velocity-encoded cine MR imaging. Radiology 185:235–240CrossRefPubMed Dulce MC, Mostbeck GH, O’Sullivan M, Cheitlin M, Caputo GR, Higgins CB (1992) Severity of aortic regurgitation: interstudy reproducibility of measurements with velocity-encoded cine MR imaging. Radiology 185:235–240CrossRefPubMed
12.
Zurück zum Zitat Fernandes SM, Khairy P, Sanders SP, Colan SD (2007) Bicuspid aortic valve morphology and interventions in the young. J Am Coll Cardiol 49:2211–2214CrossRefPubMed Fernandes SM, Khairy P, Sanders SP, Colan SD (2007) Bicuspid aortic valve morphology and interventions in the young. J Am Coll Cardiol 49:2211–2214CrossRefPubMed
13.
Zurück zum Zitat Gisler F, Knirsch W, Harpes P, Bauersfeld U (2008) Effectiveness of angiotensin-converting enzyme inhibitors in pediatric patients with mid to severe aortic valve regurgitation. Pediatr Cardiol 29:906–909CrossRefPubMed Gisler F, Knirsch W, Harpes P, Bauersfeld U (2008) Effectiveness of angiotensin-converting enzyme inhibitors in pediatric patients with mid to severe aortic valve regurgitation. Pediatr Cardiol 29:906–909CrossRefPubMed
14.
Zurück zum Zitat Goldman ME, Packer M, Horowitz SF, Meller J, Patterson RE, Kukin M, Teichholz LE, Gorlin R (1984) Relation between exercise-induced changes in ejection fraction and systolic loading conditions at rest in aortic regurgitation. J Am Coll Cardiol 3:924–929CrossRefPubMed Goldman ME, Packer M, Horowitz SF, Meller J, Patterson RE, Kukin M, Teichholz LE, Gorlin R (1984) Relation between exercise-induced changes in ejection fraction and systolic loading conditions at rest in aortic regurgitation. J Am Coll Cardiol 3:924–929CrossRefPubMed
16.
Zurück zum Zitat Grothues F, Moon JC, Bellenger NG, Smith GS, Klein HU, Pennell DJ (2004) Interstudy reproducibility of right ventricular volumes, function, and mass with cardiovascular magnetic resonance. Am Heart J 147:218–223CrossRefPubMed Grothues F, Moon JC, Bellenger NG, Smith GS, Klein HU, Pennell DJ (2004) Interstudy reproducibility of right ventricular volumes, function, and mass with cardiovascular magnetic resonance. Am Heart J 147:218–223CrossRefPubMed
17.
Zurück zum Zitat Kandakure P, Prior N, Soda G, Lim J, Dhannapuneni R, Venugopal P, Alphonso N (2014) Outcome of a repair-oriented strategy for the aortic valve in children. World J Pediatr Congenit Heart Surg 5:191–199CrossRefPubMed Kandakure P, Prior N, Soda G, Lim J, Dhannapuneni R, Venugopal P, Alphonso N (2014) Outcome of a repair-oriented strategy for the aortic valve in children. World J Pediatr Congenit Heart Surg 5:191–199CrossRefPubMed
18.
Zurück zum Zitat Karamlou T, Jang K, Williams WG, Caldarone CA, Arsdell GV, Colds JG, McCrindle BW (2005) Outcomes and associated risk factors for aortic valve replacement in 160. Children 112:3462–3469 Karamlou T, Jang K, Williams WG, Caldarone CA, Arsdell GV, Colds JG, McCrindle BW (2005) Outcomes and associated risk factors for aortic valve replacement in 160. Children 112:3462–3469
19.
20.
Zurück zum Zitat Kimball TR, Mays WA, Khoury PR, Mallie R, Claytor RP (1993) Echocardiographic determination of left ventricular preload, afterload, and contractility during and after exercise. J Pediatr 122:S89–S94CrossRefPubMed Kimball TR, Mays WA, Khoury PR, Mallie R, Claytor RP (1993) Echocardiographic determination of left ventricular preload, afterload, and contractility during and after exercise. J Pediatr 122:S89–S94CrossRefPubMed
21.
Zurück zum Zitat Kutty S, Whitehead KK, Natarajan S, Harris MA, Wernovsky G, Fogel MA (2009) Qualitative echocardiographic assessment of aortic valve regurgitation with quantitative cardiac magnetic resonance: a comparative study. Pediatr Cardiol 30:971–977CrossRefPubMed Kutty S, Whitehead KK, Natarajan S, Harris MA, Wernovsky G, Fogel MA (2009) Qualitative echocardiographic assessment of aortic valve regurgitation with quantitative cardiac magnetic resonance: a comparative study. Pediatr Cardiol 30:971–977CrossRefPubMed
22.
Zurück zum Zitat Lancellotti P, Tribouilloy C, Hagendorff A et al (2013) Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 14:611–644CrossRefPubMed Lancellotti P, Tribouilloy C, Hagendorff A et al (2013) Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 14:611–644CrossRefPubMed
23.
Zurück zum Zitat Leonardi B, Margossian R, Sanders SP, Chinali M, Colan SD (2014) Ventricular mechanics in patients with aortic valve disease: longitudinal, radial, and circumferential components. Cardiol Young 24:105–112CrossRefPubMed Leonardi B, Margossian R, Sanders SP, Chinali M, Colan SD (2014) Ventricular mechanics in patients with aortic valve disease: longitudinal, radial, and circumferential components. Cardiol Young 24:105–112CrossRefPubMed
24.
Zurück zum Zitat Lindsay J Jr, Silverman A, Van Voorhees LB, Nolan NG (1987) Prognostic implications of left ventricular function during exercise in asymptomatic patients with aortic regurgitation. Angiology 38:386–392CrossRefPubMed Lindsay J Jr, Silverman A, Van Voorhees LB, Nolan NG (1987) Prognostic implications of left ventricular function during exercise in asymptomatic patients with aortic regurgitation. Angiology 38:386–392CrossRefPubMed
25.
Zurück zum Zitat Lowenthal A, Tacy TA, Behzadian F, Punn R (2013) Echocardiographic predictors of early postsurgical myocardial dysfunction in pediatric patients with aortic valve insufficiency. Pediatr Cardiol 34:1335–1343CrossRefPubMed Lowenthal A, Tacy TA, Behzadian F, Punn R (2013) Echocardiographic predictors of early postsurgical myocardial dysfunction in pediatric patients with aortic valve insufficiency. Pediatr Cardiol 34:1335–1343CrossRefPubMed
26.
Zurück zum Zitat Malaisrie SC, McCarthy PM, McGee EC et al (2010) Contemporary perioperative results of isolated aortic valve replacement for aortic stenosis. Ann Thorac Surg 89:751–757CrossRefPubMed Malaisrie SC, McCarthy PM, McGee EC et al (2010) Contemporary perioperative results of isolated aortic valve replacement for aortic stenosis. Ann Thorac Surg 89:751–757CrossRefPubMed
27.
Zurück zum Zitat Michel PL, Iung B, Abou Jaoude S et al (1995) The effect of left ventricular systolic function on long term survival in mitral and aortic regurgitation. J Heart Valve Dis 4(Suppl 2):S160–S168PubMed Michel PL, Iung B, Abou Jaoude S et al (1995) The effect of left ventricular systolic function on long term survival in mitral and aortic regurgitation. J Heart Valve Dis 4(Suppl 2):S160–S168PubMed
28.
Zurück zum Zitat Mori Y, Nakazawa M, Tomimatsu H, Momma K (2000) Long-term effect of angiotensin-converting enzyme inhibitor in volume overloaded heart during growth: a controlled pilot study. J Am Coll Cardiol 36:270–275CrossRefPubMed Mori Y, Nakazawa M, Tomimatsu H, Momma K (2000) Long-term effect of angiotensin-converting enzyme inhibitor in volume overloaded heart during growth: a controlled pilot study. J Am Coll Cardiol 36:270–275CrossRefPubMed
29.
Zurück zum Zitat Nishimura RA, Otto CM, Bonow RO et al (2014) 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 63:2438–2488CrossRefPubMed Nishimura RA, Otto CM, Bonow RO et al (2014) 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 63:2438–2488CrossRefPubMed
30.
Zurück zum Zitat Olsen NT, Sogaard P, Larsson HB et al (2011) Speckle-tracking echocardiography for predicting outcome in chronic aortic regurgitation during conservative management and after surgery. JACC Cardiovasc Imaging 4:223–230CrossRefPubMed Olsen NT, Sogaard P, Larsson HB et al (2011) Speckle-tracking echocardiography for predicting outcome in chronic aortic regurgitation during conservative management and after surgery. JACC Cardiovasc Imaging 4:223–230CrossRefPubMed
31.
Zurück zum Zitat Onishi T, Kawai H, Tatsumi K et al (2010) Preoperative systolic strain rate predicts postoperative left ventricular dysfunction in patients with chronic aortic regurgitation. Circ Cardiovasc Imaging 3:134–141CrossRefPubMed Onishi T, Kawai H, Tatsumi K et al (2010) Preoperative systolic strain rate predicts postoperative left ventricular dysfunction in patients with chronic aortic regurgitation. Circ Cardiovasc Imaging 3:134–141CrossRefPubMed
32.
Zurück zum Zitat Rhodes J, Fischbach PS, Patel H, Hijazi ZM (2000) Factors affecting the exercise capacity of pediatric patients with aortic regurgitation. Pediatr Cardiol 21:328–333CrossRefPubMed Rhodes J, Fischbach PS, Patel H, Hijazi ZM (2000) Factors affecting the exercise capacity of pediatric patients with aortic regurgitation. Pediatr Cardiol 21:328–333CrossRefPubMed
33.
Zurück zum Zitat Ruzmetov M, Vijay P, Rodefeld MD, Turrentine MW, Brown JW (2006) Evolution of aortic valve replacement in children: a single center experience. Int J Cardiol 113:194–200CrossRefPubMed Ruzmetov M, Vijay P, Rodefeld MD, Turrentine MW, Brown JW (2006) Evolution of aortic valve replacement in children: a single center experience. Int J Cardiol 113:194–200CrossRefPubMed
34.
Zurück zum Zitat Sambola A, Tornos P, Ferreira-Gonzalez I, Evangelista A (2008) Prognostic value of preoperative indexed end-systolic left ventricle diameter in the outcome after surgery in patients with chronic aortic regurgitation. Am Heart J 155:1114–1120CrossRefPubMed Sambola A, Tornos P, Ferreira-Gonzalez I, Evangelista A (2008) Prognostic value of preoperative indexed end-systolic left ventricle diameter in the outcome after surgery in patients with chronic aortic regurgitation. Am Heart J 155:1114–1120CrossRefPubMed
35.
Zurück zum Zitat Selamet Tierney ES, Gal D, Gauvreau K, Zhou J et al (2013) Echocardiographic predictors of left ventricular dysfunction after aortic valve surgery in children and chronic aortic regurgitation. Congenit Heart Dis 8:308–315CrossRefPubMed Selamet Tierney ES, Gal D, Gauvreau K, Zhou J et al (2013) Echocardiographic predictors of left ventricular dysfunction after aortic valve surgery in children and chronic aortic regurgitation. Congenit Heart Dis 8:308–315CrossRefPubMed
36.
Zurück zum Zitat Semelka RC, Tomei E, Wagner S, Mayo J, Caputo G, O’Sullivan M, Parmley WW, Chatterjee K, Wolfe C, Higgins CB (1990) Interstudy reproducibility of dimensional and functional measurements between cine magnetic resonance studies in the morphologically abnormal left ventricle. Am Heart J 119:1367–1373CrossRefPubMed Semelka RC, Tomei E, Wagner S, Mayo J, Caputo G, O’Sullivan M, Parmley WW, Chatterjee K, Wolfe C, Higgins CB (1990) Interstudy reproducibility of dimensional and functional measurements between cine magnetic resonance studies in the morphologically abnormal left ventricle. Am Heart J 119:1367–1373CrossRefPubMed
37.
Zurück zum Zitat Tafreshi R, Shahmohammadi A, Davari P (2005) Predictors of left ventricular performance after valve replacement in children and adolescents with chronic aortic regurgitation. Pediatr Cardiol 26:331–337CrossRefPubMed Tafreshi R, Shahmohammadi A, Davari P (2005) Predictors of left ventricular performance after valve replacement in children and adolescents with chronic aortic regurgitation. Pediatr Cardiol 26:331–337CrossRefPubMed
38.
Zurück zum Zitat Trojnarska O, Siwinska A, Mularek-Kubzdela T, Szyszka A, Cieslinski A (2003) Aortic regurgitation in adults after surgical repair of tetralogy of Fallot. Kardiol Pol 59:484–491PubMed Trojnarska O, Siwinska A, Mularek-Kubzdela T, Szyszka A, Cieslinski A (2003) Aortic regurgitation in adults after surgical repair of tetralogy of Fallot. Kardiol Pol 59:484–491PubMed
39.
Zurück zum Zitat Tweddell JS, Pelech AN, Jaquiss RD, Frommelt PC, Mussatto KA, Hoffman GM, Litwin SB (2005) Aortic valve repair. Semin Thorac Cardiovasc Surg Pediatr Card Surg Ann 8:112–121CrossRef Tweddell JS, Pelech AN, Jaquiss RD, Frommelt PC, Mussatto KA, Hoffman GM, Litwin SB (2005) Aortic valve repair. Semin Thorac Cardiovasc Surg Pediatr Card Surg Ann 8:112–121CrossRef
40.
Zurück zum Zitat Vahanian A, Alfieri O, Andreotti F, Antunes MJ et al (2012) Guidelines on the management of valvular heart disease (version 2012): The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 33:2451–2496CrossRefPubMed Vahanian A, Alfieri O, Andreotti F, Antunes MJ et al (2012) Guidelines on the management of valvular heart disease (version 2012): The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 33:2451–2496CrossRefPubMed
41.
Zurück zum Zitat Vaishnava P, Fuster V, Goldman M, Bonow RO (2011) Surgery for asymptomatic degenerative aortic and mitral valve disease. Nat Rev Cardiol 8:173–177CrossRefPubMed Vaishnava P, Fuster V, Goldman M, Bonow RO (2011) Surgery for asymptomatic degenerative aortic and mitral valve disease. Nat Rev Cardiol 8:173–177CrossRefPubMed
42.
Zurück zum Zitat Wahi S, Haluska B, Pasquet A, Case C, Rimmerman CM, Marwick TH (2000) Exercise echocardiography predicts development of left ventricular dysfunction in medically and surgically treated patients with asymptomatic severe aortic regurgitation. Heart 84:606–614PubMedCentralCrossRefPubMed Wahi S, Haluska B, Pasquet A, Case C, Rimmerman CM, Marwick TH (2000) Exercise echocardiography predicts development of left ventricular dysfunction in medically and surgically treated patients with asymptomatic severe aortic regurgitation. Heart 84:606–614PubMedCentralCrossRefPubMed
43.
Zurück zum Zitat Wisenbaugh T, Spann J, Carabello B (1984) Differences in myocardial performance and load between patients with similar amounts of chronic aortic vs. chronic mitral regurgitation. J Am Coll Cardiol 3:916–923CrossRefPubMed Wisenbaugh T, Spann J, Carabello B (1984) Differences in myocardial performance and load between patients with similar amounts of chronic aortic vs. chronic mitral regurgitation. J Am Coll Cardiol 3:916–923CrossRefPubMed
44.
Zurück zum Zitat Zoghbi WA, Enriquez-Sarano M, Foster E et al (2003) Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr 16:777–802CrossRefPubMed Zoghbi WA, Enriquez-Sarano M, Foster E et al (2003) Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr 16:777–802CrossRefPubMed
Metadaten
Titel
Timing of Aortic Valve Intervention in Pediatric Chronic Aortic Insufficiency
verfasst von
Justin T. Tretter
Alan Langsner
Publikationsdatum
01.12.2014
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 8/2014
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-014-1019-y

Weitere Artikel der Ausgabe 8/2014

Pediatric Cardiology 8/2014 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.