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Neo-aortic root dilation and valve regurgitation up to 21 years after staged reconstruction for hypoplastic left heart syndrome

Meryl S. Cohen, MD^*,*, Bradley S. Marino, MD^*, Doff B. McElhinney, MD^*, Daniëlle Robbers-Visser, MD^*, Wendy van der Woerd, MD^*, J. William Gaynor, MD, Thomas L. Spray, MD and Gil Wernovsky, MD^*

^* Departments of Pediatrics, Philadelphia, Pennsylvania, USA
Surgery, University of Pennsylvania School of Medicine, The Cardiac Center at The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

View larger version (96K): [in a new window]   Figure 1 Two-dimensional echocardiographic image in parasternal long-axis view of the neo-aortic root in a 11-year-old patient with hypoplastic left heart syndrome at most recent follow-up. Diameter measurements of the valve annulus, root, and sinotubular junction are shown.

View larger version (15K): [in a new window]   Figure 2 The diameters of the neo-aortic valve annulus (left), root (middle), and sinotubular junction (right) are plotted against body surface area (BSA) and compared with the normal distribution (mean with 95% confidence intervals).

View larger version (14K): [in a new window]   Figure 3 Box plots depicting the median value (middle line of box), the 25th and 75th percentiles (upper and low boundaries of box), and 10th and 90th percentiles (upper and lower error bars) for Z-scores of the neo-aortic valve annulus (left), root (middle), and sinotubular junction (right) in the study population. Significant differences (p < 0.05) by general factorial analysis of variance with the Bonferroni correction for multiple comparisons are indicated by the following symbols: P = differs significantly from the preoperative Z-score; 1 = differs significantly from the stage 1 Z-score; 2 = differs significantly from the bidirectional superior cavopulmonary anastomosis Z-score; F = differs significantly from the Fontan Z-score.

View larger version (33K): [in a new window]   Figure 4 Bar graph depicting the percentage of patients with neo-aortic regurgitation at the various measurement intervals. Solid part of bars = moderate; dotted part of bars = mild; open part of bars = none.