Pulmonary Stenosis is a Predictor of Unfavorable Outcome After Surgery for Supravalvular Aortic Stenosis
Pediatric Cardiology, 04/10/2012KasnarSamprec J et al. –
Pulmonary stenosis (PS) in patients with supravalvular aortic stenosis (SVAS) is a risk factor for reoperations in the aortic region and might be considered an indicator of the severity of the arterial disease and a predictor of an unfavourable outcome.
The authors identified all patients with SVAS from the surgical database.
The patients with multi–level aortic stenosis or concomitant cardiac procedures were excluded from this study.
Follow–up (100 %) was conducted between 2008 and 2010.
Twenty–six patients underwent surgery for SVAS between 1974 and 2006.
Seventeen patients (65 %) were diagnosed with Williams–Beuren–Syndrome, six (17 %) had a diffuse form of SVAS and 10 (39 %) had PS.
No patient had a surgical or interventional procedure for PS at the initial operation or during follow–up.
There was no statistically significant association between PS and WBS (p=0.30) or diffuse form of SVAS (p=0.13).
Patients with PS were operated at younger age (p=0.028).
Median follow–up time was 14.6years.
Overall mortality was 11.5 %.
One patient with preoperatively severely decreased LV–function died 27days postoperatively.
Two late deaths occurred 7 and 10years after the initial operation.
Reoperations were required in 4 patients (15 %), 4–19years after the original operation, due to aortic arch stenosis, supravalvular restenosis or poststenotic aortic dilatation.
PS was found to be a risk factor for reoperation (p=0.005) and for the combined reoperation/death end–point (p=0.003).
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