Results of surgical repair of congenital supravalvular aortic stenosis

Surgical strategies and outcomes of congenital supravalvular aortic stenosis

“…Since then, several other techniques have been described: the inverted-Y shaped patch aortoplasty by Doty in 1977, 8 Brom's triple-sinuses reconstruction, 9 and autologous slide aortoplasty. 10,11 These new techniques emphasize the symmetric reconstruction of the aortic root, and theoretically offer a lower residual gradient and reintervention rate. 14 In our study, there was no death or reintervention in the Brom threepatch repair group, but our experience with this approach is fairly limited (three cases, 3.3%).…”

“…Others have described their experience with slide aortoplasty, an all-autologous reconstruction. 10,11 There is no evidence demonstrating clear superiority of any particular method. [12][13][14][15] Moreover, the optimal surgical timing is yet to be established.…”

Brom Repair for Supravalvar Aortic Stenosis

“…6,8,11,18 The Myers slide aortoplasty theoretically allows growth potential in infants and young children with a symmetric 3-sinus reconstruction of the aortic root. 16 When surgery is indicated in younger children (ie, those weighing less than 10 kg), diffuse disease is more common, and such patients are poor candidates for this repair. 10,12,19 In larger patients growth potential is less concerning.…”

“…14 More recently a number of 3-sinus repairs have been described including the Brom 3-patch aortoplasty, the Myers all-autologous slide-aortoplasty, and a similar autologous method described by Chard. [15][16][17] Proponents of 3-sinus repairs postulate that persistent geometric distortion and secondary effects on the leaflets may occur with more limited reconstructions and compromise long-term aortic valve function. 6,8,18 Theoretically, 3-sinus repairs restore more normal aortic root anatomy and will improve long-term outcomes.…”

Modified Myers and Coronary Artery Bypass Grafting Using Free Internal Thoracic Artery Graft for Complicated Supravalvular Aortic Stenosis

“…This patient showed an intermediate type between the discrete and diffuse type of SVAS, and also stenosis of the whole ascending aorta. According to the Myers method, 5 the proximal ascending aorta was extended by three sinus reconstruction and the posterior side of the distal ascending aortic flap was sutured in the left with noncoronary sinus incisions. Thereafter, the right sinus incision and the anterior wall of the ascending aorta beyond the right brachiocephalic artery were augmented by a Gore‐tex patch.…”