Neonatal Heart Can Grow After Valve Surgery
Some left heart structures can eventually reach normal size
FRIDAY, Dec. 21 (HealthDay News) -- In neonates who underwent surgery for aortic valve stenosis, some left heart structures can eventually reach normal size, according to the results of a study published in the Dec. 18/25 issue of the Journal of the American College of Cardiology.
Ra K. Han, M.D., and colleagues from the Hospital for Sick Children in Toronto, Ontario, Canada, examined outcomes and growth potential of left heart structures in 53 neonates (30 days old or less) who underwent balloon aortic valve dilation for aortic valve stenosis from 1994-2004.
The researchers found that 40 percent of patients required reintervention and 13 percent of patients died. The risk of time-related mortality was significantly higher in patients with moderate or severe left ventricular endocardial fibroelastosis (hazard ratio 22.1) and the risk of aortic valve replacement was significantly higher in patients with a smaller initial aortic valve annulus z-score (hazard ratio 0.63 per 1-U change). Some left heart dimension scores increased with time (aortic valve annulus, aortic sinus, and left ventricle dimension z-scores) while the mitral valve z-score remained below normal.
"There is potential catch-up growth of the aortic valve and left ventricle over time for neonates after intervention for aortic valve stenosis," Han and colleagues conclude. "However, the continued hypoplasia of the mitral valve warrants further consideration in the long-term management of these patients."