@article {195858, title = {Outcomes of biventricular repair for shone{\textquoteright}s complex.}, journal = {Journal of cardiac surgery}, year = {2020}, abstract = {

BACKGROUND: Shone{\textquoteright}s complex is a rare lesion affecting the mitral valve (MV) and left ventricular outflow tract (LVOT). The objective of this study is to report the outcomes after Shone{\textquoteright}s complex repair, the growth of mitral and aortic valve and LVOT, and long-term survival.

METHODS: This retrospective study included all patients diagnosed with Shone{\textquoteright}s complex, who underwent biventricular repair. Data including patients{\textquoteright} characteristics, type of the MV lesion and the associated lesions were collected. Patients were followed up regularly with echocardiography, and the changes in mitral and aortic valve z-score and LVOT z-score were recorded.

RESULTS: Thirty-seven patients were included in the study, the median age was 3.4 months, and 11 patients (30.6\%) had pulmonary hypertension. The main procedure performed during the first surgical intervention was coarctation repair in 26 patients (70\%). Twelve patients had MV repair, and five had MV replacement. Operative mortality occurred in 1 patient (2.7\%), median follow up was 52 (25-75th percentile: 22-84) months. Survival at 1, 5, and 10 years was 94.4\%, 90\%, and 76.9\%, respectively. Reoperation was required in 13 patients, mainly for LVOT repair (n = 8). Reoperation was significantly associated with associated aortic valve lesion (p = .044). The growth of the MV z-score was 0.35 per year; p \< .001, aortic valve z-score 0.086 per year; p = 0.422, and the LVOT z-score was 0.53 per year; p = .01.

CONCLUSION: Biventricular repair of Shone{\textquoteright}s complex has good outcomes. Reoperation is frequently encountered, especially with low aortic valve z-score. The MV and LVOT have significant growth following Shone{\textquoteright}s complex repair.

}, author = {Elmahrouk, Ahmed F and Ismail, Mohamed F and Arafat, Amr A and Dohain, Ahmed M and Helal, Abdelmonem M and Hamouda, Tamer E and Mohamed Galal and Edrees, Azzahra M and Al-Radi, Osman O and Jamjoom, Ahmed A} }