Early and late outcomes after surgical repair of congenital supravalvular aortic stenosis: A European Congenital Heart Surgeons Association multicentric study

Massimo A. Padalino, Anna Chiara Frigo, Marina Comisso, Martin Kostolny, Ikenna Omeje, Christian Schreiber, Jelena Pabst vonOhain, Julie Cleuziou, David J. Barron, Bart Meyns, Viktor Hraska, Bohdan Maruszewski, Michal Kozlowski, Luca Vricella, Narutoshi Hibino, Sarah Collica, Hakan Berggren, Mats Synnergren, Stojan Lazarov, David KalfaEmile Bacha, Christian Pizarro, Mark Hazekamp, Vlado Sojak, Jeffrey P. Jacobs, Matej Nosal, Jose Fragata, Sertac Cicek, George E. Sarris, Panayotis Zografos, Vladimiro L. Vida, Giovanni Stellin

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: Our goal was to evaluate the early and late results of the surgical management of congenital supravalvular aortic stenosis (SVAS). METHODS: We performed a retrospective, multicentre study using data from the European Congenital Heart Surgeons Association. Exclusion criteria were age > 18 years, operation before 1990 and redo supravalvular aortic stenosis operations. Multivariate Cox regression analysis was performed to detect independent predictors of adverse events. RESULTS: Of a total of 301 patients (male/female = 194/107; median age 3.9 years, range 13 days-17.9 years), 17.6% had a prior surgical or interventional procedure. Pulmonary artery stenosis was present in 41.5% and coronary anomalies in 13.6%. The operation consisted of a single patch repair in 36.7%, a pantaloon-shaped patch in 36.7%, a 3-patch technique in 14.3% and other techniques in 11.7%. Postoperative complications occurred in 14.9%, and the early mortality rate was 5%. At a median follow-up of 13 years (interquartile range 3.5-7.8; follow-up completed 79.1%), there were 10 late deaths (4.2%). A surgical reoperation or an interventional cardiology procedure occurred in 12.6% and 7.2%, respectively. No significant differences in outcomes between the techniques were found. Age at repair < 12 months and pulmonary artery stenosis were associated with an increased risk of early (P = 0.0001) and overall mortality (P = 0.025), respectively. Having an operation after 2005 and co-existing pulmonary artery stenosis were significant predictors of late reintervention (P = 0.0110 and P = 0.001, respectively). CONCLUSIONS: Surgical repair of congenital stenosis is an effective procedure with acceptable surgical risk and good late survival, but late morbidity is not negligible, especially in infants and when associated pulmonary artery stenosis is present.

Original languageEnglish (US)
Pages (from-to)789-797
Number of pages9
JournalEuropean Journal of Cardio-thoracic Surgery
Volume52
Issue number4
DOIs
StatePublished - Oct 1 2017

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Keywords

  • Cardiac surgery
  • Congenital cardiac defects
  • Outcomes
  • Paediatric
  • Supravalvular stenosis

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Padalino, M. A., Frigo, A. C., Comisso, M., Kostolny, M., Omeje, I., Schreiber, C., vonOhain, J. P., Cleuziou, J., Barron, D. J., Meyns, B., Hraska, V., Maruszewski, B., Kozlowski, M., Vricella, L., Hibino, N., Collica, S., Berggren, H., Synnergren, M., Lazarov, S., ... Stellin, G. (2017). Early and late outcomes after surgical repair of congenital supravalvular aortic stenosis: A European Congenital Heart Surgeons Association multicentric study. European Journal of Cardio-thoracic Surgery, 52(4), 789-797. https://doi.org/10.1093/ejcts/ezx245