| Reoperation after supravalvular aortic stenosis repair. | |
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MedLine Citation:
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PMID: 21095355 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Supravalvular aortic stenosis (SVAS) is the rarest type of left ventricular outflow tract obstruction. We reviewed our experience with this anomaly and analyzed risk factors for death or reoperation. METHODS: Between 1984 and 2009, 49 patients had surgery for SVAS. A single-patch technique was used in 3, two-sinus enlargement in 39, and three-sinus enlargement in 7. Variables evaluated included age at surgery (<2 versus >2 years old), presence of pulmonary artery stenosis, type of SVAS (focal versus diffuse), presence of valvular aortic stenosis, and era of surgery. RESULTS: The only early death occurred in a patient who experienced cardiac arrest during anesthesia induction and could not be separated from bypass after surgery. There were 2 late deaths at 3 and 11 years after SVAS repair, both related to treatment for pulmonary artery stenosis. Actuarial survival at 5, 10, and 20 years was 95%, 95%, and 90%, respectively. Sixteen patients required 23 reoperations: for pulmonary artery stenosis (n = 10), distal aortic stenosis (n = 9), aortic valve stenosis (n = 4), and coronary artery stenosis (n = 1). Actuarial reoperation-free survivals at 5, 10, and 20 years were 73%, 58%, and 52%, respectively. Coexistent pulmonary artery stenosis, young age at surgery, and diffuse type SVAS were predictors of lower freedom from death or reoperation by both univariate and multivariate analyses. CONCLUSIONS: Survival after surgical repair of SVAS is excellent. However, reoperation is frequent, especially when the patients also have pulmonary artery stenosis, diffuse type SVAS, and initial surgery at a young age. |
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Authors:
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Michiaki Imamura; Parthak Prodhan; Amy M Dossey; Robert D B Jaquiss |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 90 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-24 Completed Date: 2011-01-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 2016-22 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Pediatric Cardiothoracic Surgery, Arkansas Children's Hospital, Little Rock, Arkansas 72202, USA. imamuramichiaki@uams.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Aortic Stenosis, Supravalvular / mortality, surgery* Arkansas / epidemiology Child Child, Preschool Female Follow-Up Studies Heart Valve Prosthesis Implantation / methods* Humans Infant Infant, Newborn Male Reoperation / statistics & numerical data* Retrospective Studies Risk Factors Survival Rate Time Factors Treatment Outcome Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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