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

Mehmet G Ramoğlu1, Selen Karagözlü1, Tayfun Uçar1

  • 1Department of Pediatric Cardiology, School of Medicine, Ankara University, Ankara, Turkey.

Cardiology in the Young
|November 29, 2021
PubMed

Insights

In children with subaortic stenosis, higher initial pressure gradients are linked to adverse outcomes and reoperation. Isolated subaortic stenosis has a higher reoperation rate than other types.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease Surgery
  • Echocardiography

Background:

  • Subaortic stenosis (SAS) is a significant cause of left ventricular outflow tract obstruction in children.
  • Understanding risk factors for surgery and reoperation is crucial for optimizing patient management.
  • Comparing outcomes in isolated SAS versus SAS with congenital heart defects (CHDs) provides valuable clinical insights.

Purpose of the Study:

  • To evaluate clinical and surgical outcomes in pediatric subaortic stenosis.
  • To identify risk factors associated with initial surgery and reoperation.
  • To compare outcomes between isolated SAS and SAS concomitant with CHDs.

Main Methods:

  • Retrospective analysis of 80 children with subaortic stenosis.
  • Classification into isolated SAS and CHD groups, with further sub-classification of isolated SAS.
  • Comparison of demographic, echocardiographic, and follow-up data, correlating parameters with surgical events.

Main Results:

  • Male predominance observed across all groups.
  • Membranous type SAS was more frequent than fibromuscular type.
  • Surgery rate was similar between groups, but reoperation was higher in the isolated SAS group.
  • Higher pressure gradients were the primary predictor for surgery and reoperation.

Conclusions:

  • Isolated subaortic stenosis carries a higher risk of reoperation compared to other types.
  • Early surgical intervention may prevent aortic insufficiency but does not reduce reoperation rates.
  • Elevated initial pressure gradients are strongly associated with adverse outcomes, including recurrence and the need for reoperation.
Abstract

Keywords:
Subvalvular aortic stenosisaortoseptal anglemitral-aortic separationreoperationsurgery

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