Extended Aortoplasty to Relieve Supravalvular Aortic Stenosis

Stewart, Scott; Alexson, Chloe; Manning, James A.

doi:10.1016/s0003-4975(10)64658-9

Cited by 20 publications

(7 citation statements)

References 8 publications

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“…The proponents of the inverted bifurcated patch plasty have hypothesized that the long-term results after a symmetric anatomic restoration of the aortic root are better, but because of the rarity of the disease limited data are available. [9][10][11][12][13][14][15][16] Among the surgical series published, few allow direct comparison between the results of singlepatch enlargement and inverted bifurcated patch plasty. Reports of complex anatomic reconstructions are mostly anecdotal.…”

mentioning

confidence: 99%

Forty-one years of surgical experience with congenital supravalvular aortic stenosis

Stamm

Kreutzer

Zurakowski

et al. 1999

The Journal of Thoracic and Cardiovascular Surgery

109

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mentioning

confidence: 99%

Forty-one years of surgical experience with congenital supravalvular aortic stenosis

Stamm

Kreutzer

Zurakowski

et al. 1999

The Journal of Thoracic and Cardiovascular Surgery

109

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“…Also, diffuse hypoplasia of the aorta, as well as concomitant stenosis are risk factors for reoperation 44,45 . The surgeries include simple patch enlargement of the sinutubular junction above the noncoronary sinus or procedures involving the insertion of patches into two (inverted bifurcated patch in right and noncoronary sinus) or all three sinuses 46–49 . In cases of diffuse stenosis, also involving the supra‐aortic branch vessels, additional patch enlargement of the proximal branch arteries is also done.…”

Section: Discussionmentioning

confidence: 99%

Supravalvar aortic stenosis: Imaging characteristics and associations on multidetector computed tomography angiography

et al. 2021

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Aim To evaluate the imaging features and associations in patients with supravalvar aortic stenosis on multidetector computed tomography (CT) angiography. Materials and methods We retrospectively reviewed all CT angiography studies performed for evaluation of congenital heart diseases at our institution through the period from January 2014 to June 2020. Cases with supravalvar aortic stenosis were identified and classified as syndromic and nonsyndromic based on history, physical examination, and relevant investigations. The type and extent of vascular involvement and associated cardiovascular abnormalities were characterized. Results Supravalvar aortic stenosis was identified in 26/3926 (0.66%) patients (22 males and 4 females; Age range: 2 months to 20 years). Discrete stenosis was seen in 14/26 (53.8%) patients, while diffuse involvement of the ascending aorta to varying degrees was seen in the remaining 12 (46.2%) patients. About 15/26 (57.7%) patients had pulmonary involvement at some level, namely, infundibular, valvar, supravalvar, or peripheral pulmonic stenosis while 15/26 (57.7%) patients had coronary arterial involvement either in the form of stenosis, occlusion, or ectasia. Aortic valvular abnormality including thickening, partial fusion, and adhesion of leaflet edges to the sinutubular junction causing reduced coronary inflow was seen in 15/26 (57.7%) patients. Associated ventricular septal defect, patent ductus arteriosus, and mitral valvular prolapse were seen in four (15.4%), five (19.2%), and two (7.7%) patients respectively. Conclusion Supravalvar aortic stenosis is a rare abnormality showing associated pulmonary arterial involvement, coronary arterial involvement, aortic valvular abnormalities, and associated congenital cardiac defects in the majority of cases, which may influence surgical outcomes.

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“…It is generally believed that the main pathological change involved in SVAS is sinotubular junction stenosis; however, other obstructions can also occur in the ascending aorta, aortic arch, innominate artery, or carotid artery. [5][6][7][8][9][10][11][12][13] The sinotubular junction plays an important role in maintaining the flexibility of the aorta in the systolic and diastolic periods. In SVAS, a hyperplastic ridge develops at the sinotubular junction, seriously affecting the function of both the sinotubular junction and aortic valve during systole.…”

Section: Discussionmentioning

confidence: 99%

Avoidance of malignant arrhythmia caused by displacement of the right coronary artery ostium in surgical correction of supravalvular aortic stenosis

Peng¹,

Wang²

2019

J Int Med Res

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ObjectiveThis study was performed to identify the effects of different surgical approaches on the right coronary artery ostium in patients with congenital supravalvular aortic stenosis (SVAS) and to determine how to avoid surgically induced right coronary artery occlusion.MethodsThe surgical techniques and outcomes of 91 patients who underwent surgical treatment of SVAS from 2008 to 2015 in our institution were retrospectively reviewed to identify the causes of early death, reoperation, and extracorporeal membrane oxygenation (ECMO) support.ResultsFour perioperative deaths (Doty’s technique, n = 4), six cases of ECMO support (Doty’s technique, n = 4; Brom’s technique, n = 1; McGoon’s technique, n = 1), and eight reoperations (Doty’s technique, n = 5; Brom’s technique, n = 2; McGoon’s technique, n = 1) occurred. In cases of reoperation, adjustment of the shape and position of the right coronary sinus patch relieved the malignant arrhythmia.ConclusionDifferent surgical techniques have different effects on the right coronary artery. The shape of the patch inserted into the right coronary sinus should be carefully clipped to avoid distortion and ischemia of the right coronary artery.

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Extended Aortoplasty to Relieve Supravalvular Aortic Stenosis

Cited by 20 publications

References 8 publications

Forty-one years of surgical experience with congenital supravalvular aortic stenosis

Forty-one years of surgical experience with congenital supravalvular aortic stenosis

Supravalvar aortic stenosis: Imaging characteristics and associations on multidetector computed tomography angiography

Avoidance of malignant arrhythmia caused by displacement of the right coronary artery ostium in surgical correction of supravalvular aortic stenosis

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