ABC | Volume 111, Nº1, July 2018

Original Article Martins et al Regurgitation aortic after Jatene Surgery Arq Bras Cardiol. 2018; 111(1):21-28 Table 4 – Comparison between the preoperative Z-score mean of pulmonary artery and the postoperative Z-score mean of aortic annulus of the simple TGA and complex TGA groups Z-score (Complex TGA) Mean ± standard-deviation Difference between the means Paired t test P value Pre 1.9 ± 1.1 -0.3 ± 0.4 4.88 < 0.0001 Post 2.2 ± 1.3 Z-score (Simple TGA) Mean ± standard-deviation Difference between the means Paired t test P value Pre 1.6 ± 0.7 -0.2 ± 0.3 4.81 < 0.0001 Post 1.8 ± 1.0 *p < 0.0001. TGA: transposition of the great arteries. Table 5 – Assessment of the neo-aortic valve regurgitation grade of 127 patients of the simple TGA and complex TGA groups submitted to Jatene surgery Groups Absent/trivial regurgitation Mild regurgitation Moderate regurgitation Total Simple TGA 74 (82.2%) 5 (38.4%) 5 (20.8%) 84 Complex TGA 16 (17.7%) 8 (61.5%) 19 (79.1%) 43 Total 90 (70.8%) 13 (10.2%) 24 (18.9%) 127 Chi-square = 34.85; p < 0.0001. TGA: transposition of the great arteries. Table 6 – Z-score means of the aortic annulus according to the regurgitation grade in the postoperative follow-up of 127 patients submitted to Jatene surgery Regurgitation grade n Mean ± standard-deviation Analysis of variance F Absent/trivial 90 1.72 ± 0.98 cm F 6.66 Mild 13 2.18 ± 0.83 cm Moderate 24 2.60 ± 1.40 cm F = 6.6 Table 7 – Age means at the control times according to the neo-aortic valve regurgitation grade during the follow-up of 127 patients submitted to Jatene surgery Regurgitation grade n Mean ± standard-deviation Analysis of variance F Absent/trivial 90 7.08 ± 4.74 anos F 5.4 Mild 13 5.60 ± 4.16 anos Moderate 24 9.81 ± 4.21 anos F = 5.4 in 10 years is still low (2-2.5%), 6,16-19 several authors have reported that the development of neo-aorta regurgitation and dilation is a time-dependent phenomenon, requiring a strict vigilance of the patients. 6,20,21 McMahon et al. 22 have found a moderate enlargement in the neo-aortic root (Z-score between 3 and 4) in 52% of the patients, and a severe enlargement of the neo-aortic root (Z-score > 5) in 25%. In addition, those authors have shown that the development of significant neo-aortic valve regurgitation strongly associated with the development of neo-aorta dilation, which has been confirmed by other authors. 23 Schwartz et al. 24 have concluded that, after Jatene surgery, neo-aortic root dilation and neo-aortic valve regurgitation continue to develop over time, but aortic root dilation does not tend to be progressive during late follow‑up. However, in that series, the last follow‑up was up to 16 years, while Walter et al. 19 have concluded that neo-aortic regurgitation can develop in up to 15 years. In our sample, two patients required reintervention for progressive neo-aortic root dilation associated with neo‑aortic regurgitation in a follow-up of 9.81 ± 4.21 years. Some studies have shown the significance of several risk factors to the development of late neo-aortic valve regurgitation and aortic root dilation, such as preoperative pulmonary artery dilation, patient’s age over one year at the 25