Pediatric Heart Expert Forum
Dilation of 77ml
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Dilation of 77ml

My 15 year old son had a transposition of the great arteries when he was newborn; 7 days old.
Since then he has always has a slight leakage.  In 2012 it was mild, in July 2012 it was 20% and in February  2013 it was 21%.
His July 2012 MRI and ultrasound indicated the left pumping chamber of the aortic valve at 57ml.  However his February 2013 MRI revealed is was now 77ml.  An ultrasound was not performed but will now be done within the next few weeks to confirm the results prior to making any decisions.  
During 2012 and 2013 his weight and height didn’t change.  He is 5’6’’ and 115 pounds.  He is active and eats well.  
My understanding is the dilation cannot decrease and that either the valve must be repaired or replaced.   Given his age repairing the valve would be the best option.  
What is usually recommended for a dilation of 77ml?
What does repairing the valve include?
What can I expect as he grows older?
What are the impacts of having this type of surgery done at 15 years old?

Thank you.
Tags: Heart
773655_tn?1340656399
I am assuming that your son's TGA (transposition of the great arteries) was treated with an arterial switch operation (ASO). If that is correct, then I assume that the leaky valve you are referring to is the "aortic" valve (former pulmonary valve) if that is correct, and the aortic valve regurgitant fraction is 23%, that falls in the mild range of valve leakage and would not be enough to generally warrant a valve surgery.  Also an LV volume of 77 mL is not severely dilated for his age. It sounds like there have been some changes as he has grown which is to be expected.  I cannot tell you how a surgeon would treat his valve without knowing other things: is the aortic root dilated and this is leafing to the leakage (commonly seen). Sometimes the surgeon can just tighten up the natural valve, while other times it needs to be replaced.  It sounds like you will need to have these questions ready for your cardiologist to discuss after the next echo is done. Even after a good valve repair, chronic wear and tear can lead to future surgery if the valve leaks significantly.  Usually surgery is only performed when the valve leak is severe, if the left ventricle enlarges too fast too quickly, or if the aortic root dilates over 5 cm in size.  Good luck.
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