Long-term follow-up of subvalvular aortic stenosis in children: a single-centre experience
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. The study involved 80 children with subaortic stenosis. The p...
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| Veröffentlicht in: | Cardiology in the young 2022-06, Vol.32 (6), p.980-987 |
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| creator | Ramoğlu, Mehmet G. Karagözlü, Selen Uçar, Tayfun Eyileten, Zeynep Uysalel, Adnan Atalay, Semra Tutar, Ercan |
| description | 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.
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.
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.
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. |
| doi_str_mv | 10.1017/S1047951121004686 |
| format | Article |
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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.
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.
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.</description><identifier>ISSN: 1047-9511</identifier><identifier>EISSN: 1467-1107</identifier><identifier>DOI: 10.1017/S1047951121004686</identifier><identifier>PMID: 34839837</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Age ; Aorta ; Aortic stenosis ; Aortic Stenosis, Subvalvular - diagnostic imaging ; Aortic Stenosis, Subvalvular - epidemiology ; Aortic Stenosis, Subvalvular - surgery ; Aortic Valve Insufficiency - surgery ; Aortic Valve Stenosis - surgery ; Cardiology ; Catheters ; Child ; Children ; Constriction, Pathologic - surgery ; Coronary vessels ; Dyspnea ; Female ; Follow-Up Studies ; General Cardiology ; Humans ; Male ; Medical imaging ; Morphology ; Original Article ; Parameters ; Patients ; Pediatrics ; Reoperation ; Risk factors ; Surgery ; Surgical outcomes</subject><ispartof>Cardiology in the young, 2022-06, Vol.32 (6), p.980-987</ispartof><rights>The Author(s), 2021. Published by Cambridge University Press</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c373t-6bbe8d69de6d104d75af275a3c09cae50c049392f2787ae52caf96343bf655b63</citedby><cites>FETCH-LOGICAL-c373t-6bbe8d69de6d104d75af275a3c09cae50c049392f2787ae52caf96343bf655b63</cites><orcidid>0000-0003-3386-0691 ; 0000-0001-5395-7111 ; 0000-0003-0795-0810 ; 0000-0002-4684-7827 ; 0000-0003-3405-7139 ; 0000-0002-4117-0685 ; 0000-0002-9542-1937</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S1047951121004686/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,314,780,784,27924,27925,55628</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34839837$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ramoğlu, Mehmet G.</creatorcontrib><creatorcontrib>Karagözlü, Selen</creatorcontrib><creatorcontrib>Uçar, Tayfun</creatorcontrib><creatorcontrib>Eyileten, Zeynep</creatorcontrib><creatorcontrib>Uysalel, Adnan</creatorcontrib><creatorcontrib>Atalay, Semra</creatorcontrib><creatorcontrib>Tutar, Ercan</creatorcontrib><title>Long-term follow-up of subvalvular aortic stenosis in children: a single-centre experience</title><title>Cardiology in the young</title><addtitle>Cardiol Young</addtitle><description>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.
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.
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.
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.</description><subject>Age</subject><subject>Aorta</subject><subject>Aortic stenosis</subject><subject>Aortic Stenosis, Subvalvular - diagnostic imaging</subject><subject>Aortic Stenosis, Subvalvular - epidemiology</subject><subject>Aortic Stenosis, Subvalvular - surgery</subject><subject>Aortic Valve Insufficiency - surgery</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Cardiology</subject><subject>Catheters</subject><subject>Child</subject><subject>Children</subject><subject>Constriction, Pathologic - surgery</subject><subject>Coronary vessels</subject><subject>Dyspnea</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>General Cardiology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Morphology</subject><subject>Original Article</subject><subject>Parameters</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Reoperation</subject><subject>Risk factors</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><issn>1047-9511</issn><issn>1467-1107</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1UMtKxDAUDaI4OvoBbiTgxk01adKkdSfiCwZcqBs3JU1vxwxpMiatj7834qiguLnPc869HIT2KDmihMrjW0q4rApKc0oIF6VYQ1uUC5lRSuR6qtM6-9hP0HaMC0IoY5RsognjJatKJrfQw8y7eTZA6HHnrfUv2bjEvsNxbJ6VfR6tClj5MBiN4wDORxOxcVg_GtsGcCdY4Wjc3EKmwQ0BMLwuIRhwGnbQRqdshN1VnqL7i_O7s6tsdnN5fXY6yzSTbMhE00DZiqoF0aaHW1moLk-BaVJpBQXRhFesytOwlKnPteoqwThrOlEUjWBTdPipuwz-aYQ41L2JGqxVDvwY61wQzkUucpmgB7-gCz8Gl76r85IJwkqebJki-onSwccYoKuXwfQqvNWU1B_G13-MT5z9lfLY9NB-M76cTgC2ElV9E0w7h5_b_8u-A-w1jMQ</recordid><startdate>20220601</startdate><enddate>20220601</enddate><creator>Ramoğlu, Mehmet G.</creator><creator>Karagözlü, Selen</creator><creator>Uçar, Tayfun</creator><creator>Eyileten, Zeynep</creator><creator>Uysalel, Adnan</creator><creator>Atalay, Semra</creator><creator>Tutar, Ercan</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3386-0691</orcidid><orcidid>https://orcid.org/0000-0001-5395-7111</orcidid><orcidid>https://orcid.org/0000-0003-0795-0810</orcidid><orcidid>https://orcid.org/0000-0002-4684-7827</orcidid><orcidid>https://orcid.org/0000-0003-3405-7139</orcidid><orcidid>https://orcid.org/0000-0002-4117-0685</orcidid><orcidid>https://orcid.org/0000-0002-9542-1937</orcidid></search><sort><creationdate>20220601</creationdate><title>Long-term follow-up of subvalvular aortic stenosis in children: a single-centre experience</title><author>Ramoğlu, Mehmet G. ; Karagözlü, Selen ; Uçar, Tayfun ; Eyileten, Zeynep ; Uysalel, Adnan ; Atalay, Semra ; Tutar, Ercan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c373t-6bbe8d69de6d104d75af275a3c09cae50c049392f2787ae52caf96343bf655b63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Age</topic><topic>Aorta</topic><topic>Aortic stenosis</topic><topic>Aortic Stenosis, Subvalvular - diagnostic imaging</topic><topic>Aortic Stenosis, Subvalvular - epidemiology</topic><topic>Aortic Stenosis, Subvalvular - surgery</topic><topic>Aortic Valve Insufficiency - surgery</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Cardiology</topic><topic>Catheters</topic><topic>Child</topic><topic>Children</topic><topic>Constriction, Pathologic - surgery</topic><topic>Coronary vessels</topic><topic>Dyspnea</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>General Cardiology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Morphology</topic><topic>Original Article</topic><topic>Parameters</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Reoperation</topic><topic>Risk factors</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ramoğlu, Mehmet G.</creatorcontrib><creatorcontrib>Karagözlü, Selen</creatorcontrib><creatorcontrib>Uçar, Tayfun</creatorcontrib><creatorcontrib>Eyileten, Zeynep</creatorcontrib><creatorcontrib>Uysalel, Adnan</creatorcontrib><creatorcontrib>Atalay, Semra</creatorcontrib><creatorcontrib>Tutar, Ercan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Cardiology in the young</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ramoğlu, Mehmet G.</au><au>Karagözlü, Selen</au><au>Uçar, Tayfun</au><au>Eyileten, Zeynep</au><au>Uysalel, Adnan</au><au>Atalay, Semra</au><au>Tutar, Ercan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term follow-up of subvalvular aortic stenosis in children: a single-centre experience</atitle><jtitle>Cardiology in the young</jtitle><addtitle>Cardiol Young</addtitle><date>2022-06-01</date><risdate>2022</risdate><volume>32</volume><issue>6</issue><spage>980</spage><epage>987</epage><pages>980-987</pages><issn>1047-9511</issn><eissn>1467-1107</eissn><abstract>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.
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.
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.
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.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>34839837</pmid><doi>10.1017/S1047951121004686</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3386-0691</orcidid><orcidid>https://orcid.org/0000-0001-5395-7111</orcidid><orcidid>https://orcid.org/0000-0003-0795-0810</orcidid><orcidid>https://orcid.org/0000-0002-4684-7827</orcidid><orcidid>https://orcid.org/0000-0003-3405-7139</orcidid><orcidid>https://orcid.org/0000-0002-4117-0685</orcidid><orcidid>https://orcid.org/0000-0002-9542-1937</orcidid></addata></record> |
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| subjects | Age Aorta Aortic stenosis Aortic Stenosis, Subvalvular - diagnostic imaging Aortic Stenosis, Subvalvular - epidemiology Aortic Stenosis, Subvalvular - surgery Aortic Valve Insufficiency - surgery Aortic Valve Stenosis - surgery Cardiology Catheters Child Children Constriction, Pathologic - surgery Coronary vessels Dyspnea Female Follow-Up Studies General Cardiology Humans Male Medical imaging Morphology Original Article Parameters Patients Pediatrics Reoperation Risk factors Surgery Surgical outcomes |
| title | Long-term follow-up of subvalvular aortic stenosis in children: a single-centre experience |
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