{
  "abstract": "Objective\n\nTo evaluate the midterm outcomes of the aortic valve neocuspidalization (AVNeo) procedure for aortic valve reconstruction in 83 pediatric patients with complex aortic valve disease and to identify risk factors associated with the outcomes.Methods\n\nA retrospective analysis was conducted on pediatric patients who underwent the AVNeo procedure between January 2017 and June 2025. The composite primary end point included all-cause mortality, reoperation, or moderate-to-severe aortic valve dysfunction (regurgitation or stenosis). Univariate and multivariate Cox proportional hazards models were used to identify risk factors.Results\n\nAmong the 83 patients (mean age 7.0 ± 3.7 years; 67.5% male) included in the analysis, the predominant preoperative pathology was moderate-to-severe aortic regurgitation (88.0%). Single-leaflet reconstruction (65.1%) using autologous pericardium (94.0%) was the most common surgical approach. Over a mean follow-up of 28.4 ± 23.9 months, 27 patients (32.5%) met the composite end point, including 2 late deaths, 18 cases of moderate-to-severe regurgitation, and 9 cases of moderate-to-severe stenosis; 10 patients underwent reoperation. The probability of freedom from the primary end point was 83.6%, 64.5%, and 54.4% at 1, 3, and 6 years, respectively. Multivariable analysis identified tricuspid aortic valve morphology as an independent protective factor against the primary end point (hazard ratio, 0.408; 95% CI, 0.178-0.935, P = .034), whereas the use of autologous pericardium showed a strong protective trend (hazard ratio, 0.284; 95% CI, 0.078-1.037, P = .057).Conclusions\n\nAVNeo provides midterm outcomes that support its use as an alternative strategy. Tricuspid aortic valve morphology is a strong predictor of favorable outcomes, and the use of autologous pericardium demonstrates significant potential as a protective factor.",
  "abstract_shown": true,
  "affiliations": [
    "Pediatric Cardiac Surgery Center, National Center for Cardiovascular Diseases and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.",
    "Adult Cardiac Surgery Center, National Center for Cardiovascular Diseases and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.",
    "Department of Echocardiography, National Center for Cardiovascular Diseases and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Guanxi Wang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Sen Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Kai Ma"
    },
    {
      "affs": [
        2
      ],
      "name": "Kunjing Pang"
    },
    {
      "affs": [
        0
      ],
      "name": "Benqing Zhang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Keming Yang"
    },
    {
      "affs": [
        0
      ],
      "name": "Shoujun Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cfczx17g848ex.bib",
  "cited_by": 0,
  "doi": "10.1016/j.xjon.2026.101958",
  "fulltext_url": "https://europepmc.org/articles/PMC13711218",
  "id": "cfczx17g848ex",
  "issns": [
    "2666-2736"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948439",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Congenital: Aortic Valve"
    ],
    [
      "openalex",
      "2705|Cardiac Valve Diseases and Treatments"
    ]
  ],
  "openalex": "W7167818663",
  "pdf_url": "https://europepmc.org/articles/PMC13711218?pdf=render",
  "pmcid": "PMC13711218",
  "pmid": "42948439",
  "published": "2026-07-09",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/cfczx17g848ex.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:36Z",
      "native_id": "MED:42948439",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948439"
    },
    {
      "first_seen": "2026-10-31T12:22:02Z",
      "native_id": "PMC13711218",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.xjon.2026.101958"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiac Valve Diseases and Treatments",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Tricuspid aortic valve morphology predicts favorable midterm outcomes after aortic valve neocuspidization in children.",
  "title_text": "Tricuspid aortic valve morphology predicts favorable midterm outcomes after aortic valve neocuspidization in children.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:02Z",
  "url": "https://research.draconitic.com/paper/cfczx17g848ex",
  "venue": "JTCVS open",
  "versions": []
}