Long-term outcomes and risk factors for aortic regurgitation after discrete subvalvular aortic stenosis resection in children

Pickard, Sarah S.; Geva, Alon; Nido, Pedro J. del; Geva, Tal

doi:10.1136/heartjnl-2015-307460

Cited by 27 publications

(30 citation statements)

References 32 publications

(54 reference statements)

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“…According to Pickard et al, risk factors for reoperation by multivariable analysis included younger age at resection (HR 1.24, p=0.003), peeling of membrane off aortic valve or mitral valve (HR 2.52, p=0.01), preoperative gradient ≥60 mm Hg (HR 2.23, p=0.04), AS (HR 2.58, p=0.01) and distance of membrane to aortic valve<7.0 mm (HR 4.03, p=0.03). 16 The primary results of DSS resection in our study were good. Like other studies the LV-aorta gradients decreased significantly studies similar to ours.…”

Section: Concomitant Lesion Numbermentioning

confidence: 68%

Subaortic Membrane; Surgical Results of Resection. A Single Centre Experience.

Waqar¹

2017

TPMJ

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ABSTRACT… Objectives:In this study, we presented our results regarding outcomes of surgical correction of sub-aortic membrane. Study Design: Retrospective observational study. Period: June 2012 to June 2017. Setting: CPEIC Multan, Pakistan. Methods: 51 patients operated for resection of sub aortic membrane. The resection of sub aortic membrane was done through the aorta. Evaluation of the aortic valve done in all patients. The aortic valve was either replaced or repaired in cases of severe aortic regurgitation. Associated lesions such as ventricular septal defects (VSD's) were repaired with a dacron patch through the right atrium while ASD's were repaired with a pericardial patch. Post-operative echocardiography was done before discharge and post-op LVOT gradients and aortic insufficiency were recorded for all the patients. Results: There were 36 males and 15 females whose mean ages were 16.29 years. On post-op echocardiography there was no residual significant LVOT gradient in any patient. Three (3) patients developed mild to moderate aortic regurgitation post operatively but none of them warrant any surgical intervention. There was only 1 death in the series which was due to VSD patch dehiscence. None of the patients developed conduction problems post operatively needing any permanent pace maker. Mean pre-op LVOT gradient was 94.7 mmHg while it reduced to 20.7 post operatively (p-value <0.001). Conclusion: We concluded that early resection of sub aortic membrane can be safely accomplished with good results and significant drop in the mean LVOT pressure gradients post operatively. Key words:Left Ventricle Outflow Obstruction, Aortic Regurgitation, Bacterial Endocarditis.

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Section: Concomitant Lesion Numbermentioning

confidence: 68%

Subaortic Membrane; Surgical Results of Resection. A Single Centre Experience.

Waqar¹

2017

TPMJ

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“…AR is associated with discrete SubAM in a vast majority of patients (40‐80%) at presentation . The turbulence and the ejection systolic jets hitting the aortic valve cause damage to the valve leaflets, causing thickening of the leaflets and prolapse leading to deficient coaptation causing AR .…”

Section: Discussionmentioning

confidence: 99%

Resection of subaortic membrane for discrete subaortic stenosis

et al. 2017

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“…Overall survival of adults with DSS without associated congenital lesions or valvar aortic stenosis is excellent and equivalent to that of the age-matched population. 24 …”

Section: Imagingmentioning

confidence: 99%

Imaging adult patients with discrete subvalvar aortic stenosis

Opotowsky

Pickard²,

Geva³

2017

Current Opinion in Cardiology

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Purpose of review Distinction between discrete subvalvar aortic stenosis and other causes of left ventricular outflow obstruction has important implications for predicting natural history and guiding the timing and type of intervention. Imaging, primarily transthoracic echocardiography, plays a pivotal role in the diagnosis and management of adults with subvalvar stenosis. Recent findings The majority of systematic research on imaging of subvalvar aortic stenosis has focused on echocardiography. Transthoracic echocardiography, especially two-dimensional imaging with color and spectral Doppler, remains the main modality for delineation of the anatomic and hemodynamic features of subvalvar stenosis, associated anomalies, and involvement of accessory mitral valve attachments to the subaortic septum or abnormally placed papillary muscles. Transesophageal echocardiography may provide a more detailed definition of left ventricular outflow tract anatomy, including the presence and extension of the obstructive subaortic fibroelastic tissue onto the aortic or mitral valve, especially in patients with poor transthoracic windows. The clinical role for advanced imaging technologies, including 3-dimensional echocardiography, cardiac magnetic resonance, and computed tomography, is evolving but, largely because of the adequacy of established imaging with transthoracic echocardiography, remains relatively limited. Summary In the absence of other congenital heart defects or alternative indications (e.g., coronary angiography), transthoracic echocardiography is usually adequate for assessment of discrete subvalvar aortic stenosis in the adult. In specific clinical situations, supplemental imaging modalities can play an integral role in clinical decision making.

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Long-term outcomes and risk factors for aortic regurgitation after discrete subvalvular aortic stenosis resection in children

Cited by 27 publications

References 32 publications

Subaortic Membrane; Surgical Results of Resection. A Single Centre Experience.

Subaortic Membrane; Surgical Results of Resection. A Single Centre Experience.

Resection of subaortic membrane for discrete subaortic stenosis

Imaging adult patients with discrete subvalvar aortic stenosis

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