Surgical outcome of partial Shone complex

Interact Cardiovasc Thorac Surg. 2012 Apr;14(4):440-4. doi: 10.1093/icvts/ivr169. Epub 2012 Jan 25.

Abstract

Partial forms of Shone complex are rare. Surgical outcomes of the complete forms have generally been poor, whereas there is a lack of data on long-term follow-up of surgically treated adult partial complex. Between 2001 and 2011, nine patients (age: 38 ± 8 years; six males, 67%) were referred for valvular heart disease. Transthoracic and transoesophageal echocardiography was performed. Data were confirmed by intra-operative findings and reports. Patients were diagnosed as partial Shone complex and presented with mitral stenosis (MS) (45%) or mitral regurgitation (22%) or aortic regurgitation (22%). All but one patient (89%) reported previous surgery: coarctation of the aorta repair (87.5%) and aortic valvulotomy (12.5%). Redo intervention included: mitral valve replacement (25%), mitral repair (25%), aortic valve replacement (37.5%) and subvalvular aortic ridge resection (25%). One patient refused surgery. Patients surgically treated before the age of 5 (87.5%) showed favourable outcome (survival rate: 100%) and a 23.6 (± 4.6)-year follow-up free from events. The patient who underwent first intervention at the age of 50 and the patient with MS who refused surgery showed a 45 (± 7)-year follow-up free from major morbidity. Patients with partial Shone complex, properly diagnosed and treated, show favourable surgical outcome free from major clinical events.

MeSH terms

  • Adult
  • Aortic Valve / abnormalities
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / surgery*
  • Child, Preschool
  • Disease-Free Survival
  • Echocardiography, Doppler, Color
  • Echocardiography, Transesophageal
  • Female
  • Heart Defects, Congenital / diagnostic imaging
  • Heart Defects, Congenital / surgery*
  • Heart Valve Prosthesis Implantation*
  • Humans
  • Infant
  • Italy
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Mitral Valve / abnormalities
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / surgery*
  • Predictive Value of Tests
  • Reoperation
  • Time Factors
  • Treatment Outcome
  • Young Adult