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Long-term follow-up of subvalvular aortic stenosis in children: a single-centre experience

Part of: Echocardiography

Published online by Cambridge University Press:  29 November 2021

Mehmet G. Ramoğlu Open the ORCID record for Mehmet G. Ramoğlu [Opens in a new window] ,
Selen Karagözlü Open the ORCID record for Selen Karagözlü [Opens in a new window] ,
Tayfun Uçar Open the ORCID record for Tayfun Uçar [Opens in a new window] ,
Zeynep Eyileten Open the ORCID record for Zeynep Eyileten [Opens in a new window] ,
Adnan Uysalel Open the ORCID record for Adnan Uysalel [Opens in a new window] ,
Semra Atalay Open the ORCID record for Semra Atalay [Opens in a new window]  and
Ercan Tutar Open the ORCID record for Ercan Tutar [Opens in a new window]
Mehmet G. Ramoğlu
Affiliation:
Department of Pediatric Cardiology, School of Medicine, Ankara University, Ankara, Turkey
Selen Karagözlü
Affiliation:
Department of Pediatric Cardiology, School of Medicine, Ankara University, Ankara, Turkey
Tayfun Uçar
Affiliation:
Department of Pediatric Cardiology, School of Medicine, Ankara University, Ankara, Turkey
Zeynep Eyileten
Affiliation:
Department of Pediatric Cardiovascular Surgery, School of Medicine, Ankara University, Ankara, Turkey
Adnan Uysalel
Affiliation:
Department of Pediatric Cardiovascular Surgery, School of Medicine, Ankara University, Ankara, Turkey
Semra Atalay
Affiliation:
Department of Pediatric Cardiology, School of Medicine, Ankara University, Ankara, Turkey
Ercan Tutar*
Affiliation:
Department of Pediatric Cardiology, School of Medicine, Ankara University, Ankara, Turkey
*
Author for correspondence: Prof. Dr E. Tutar, Ankara Üniversitesi Tıp Fakültesi Hastanesi, Tıp Fakültesi Caddesi, Cebeci, Çankaya, Ankara06590, Turkey. Tel: +905323451201; Fax: +903123106371. E-mail: [email protected]
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Abstract

Objective:

The aim of this study is to evaluate clinical and surgical outcomes of children with subaortic stenosis, to determine the risk factors for surgery and reoperation and to compare isolated subaortic stenosis and those concomitant with CHDs.

Methods:

The study involved 80 children with subaortic stenosis. The patients were first classified as isolated and CHD group, and the isolated group was further classified as membranous/fibromuscular group. The initial, pre-operative, post-operative and the most recent echocardiographic data, demographic properties and follow-up results of the groups were analysed and compared. The correlation of echocardiographic parameters with surgery and reoperation was evaluated.

Results:

There was a significant male predominance in all groups. The frequency of the membranous type was higher than the fibromuscular type in the whole and the CHD group. The median time to the first operation was 4.6 years. Thirty-five (43.7%) patients underwent surgery, 5 of 35 (14%) patients required reoperation. The rate of surgery was similar between groups, but reoperation was significantly higher in the isolated group. The gradient was the most important factor for surgery and reoperation in both groups. In the isolated group besides gradient, mitral-aortic separation was the only echocardiographic parameter correlated with surgery and reoperation.

Conclusion:

Reoperation is higher in isolated subaortic stenosis but similar in membranous and fibromuscular types. Early surgery may be beneficial in preventing aortic insufficiency but does not affect the rate of reoperation. Higher initial gradients are associated with adverse outcomes, recurrence and reoperation.

Keywords

Subvalvular aortic stenosissurgeryreoperationmitral-aortic separationaortoseptal angle
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 6 , June 2022 , pp. 980 - 987
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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