Evaluation of midterm outcomes after Shone's complex surgery: Analysis of reoperation and mortality risk factors

J Card Surg. 2022 Dec;37(12):5153-5161. doi: 10.1111/jocs.17163.

Abstract

Objective: The midterm results of patients who underwent biventricular repair surgery for Shone's complex were examined, and mortality and reoperation risk factors were evaluated.

Methods: This retrospective study included 34 patients with Shone's complex who underwent mitral valve (MV) surgery between 2005 and 2020.

Results: A total of 19 patients (56%) had coarctation, 10 (29%) patients had subaortic stenosis, 9 (26.5%) patients had a hypoplastic aortic arch (AA), and 9 (26.5%) patients had aortic valve (AV) stenosis. Twenty-four (70.6%) patients had bileaflet AV. Associated left-sided in-flow stenotic lesions included parachute MV in 19 (56%) patients and supramitral ring in 18 (53%) patients. The estimated freedom from reoperation rate on the 6th month, 1 year and 2 years after surgery was 84.4%, 79.5%, and 71.5%, respectively. The overall mortality rate was 20.6% (seven patients) with a median follow-up of 10 months (0-41). The estimated survival rate on the 6th month, 1 year, and 3 years after surgery was 83.8%, 79.4%, and 79.4 respectively. Bicuspid aortic valve (p = .017) (HR (95% CI) = 0.130 (0.025-0.695) and hammock mitral valve (p = .038) (HR (95% CI) = 11,008 (1,146->100) were associated with mortality.

Conclusion: The presence of a bicuspid aortic valve hammock mitral valve might have an effect on negative effect on the outcome.

Keywords: Shone's complex; bicuspid aortic valve; mitral stenosis; mortality; reoperation.

MeSH terms

  • Aortic Coarctation* / surgery
  • Aortic Valve Stenosis* / surgery
  • Bicuspid Aortic Valve Disease* / surgery
  • Constriction, Pathologic / surgery
  • Follow-Up Studies
  • Heart Defects, Congenital* / surgery
  • Humans
  • Mitral Valve Stenosis* / surgery
  • Reoperation
  • Retrospective Studies
  • Risk Factors