Early and mid-term outcomes after surgical repair of congenital supravalvular aortic stenosis by Doty technique

Işık, Onur; Akyüz, Muhammet; Karakuş, Engin; Işık, Esra; Ayık, Mehmet Fatih; Levent, Ertürk; Atay, Yüksel

doi:10.5543/tkda.2018.65960

Cited by 3 publications

(3 citation statements)

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“…Previous studies indicated that preoperative combined pulmonary stenosis, PVS, and bicuspid aortic valve were risk factors for adverse events in the surgical treatment of SVAS [ 4 , 19 ]. In addition, the mortality rate was lower compared with other centers (3.1–10%) [ 20 , 21 , 22 ]. Therefore, considering the poor preoperative baseline in the pericardium patch group, the pericardium patch performed acceptably in terms of safety.…”

Section: Discussionmentioning

confidence: 67%

Effectiveness and Safety of Different Patch Materials for Supravalvar Aortic Stenosis (Middle-Term Outcomes)

Lang,

Lv,

Zhang

et al. 2024

Rev. Cardiovasc. Med.

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Background: To determine the effectiveness and safety of different patch materials in the treatment of pediatric patients with congenital supravalvular aortic stenosis (SVAS). Methods: 218 consecutive SVAS patients (age 14 years) who underwent surgery from Beijing Fuwai and Yunnan Fuwai hospital between 2002 and 2020 were included. Patients were divided into the pericardium patch group (133 (61.0%)), modified patch group (43 (19.7%)) and artificial patch group (42 (19.3%)). The primary safety endpoint was patch-related adverse complications (post-operation patch hemorrhage or aortic sinus aneurysm at 2-year follow-up). The primary effectiveness outcome was the re-operation or restenosis at 2-year follow-up. Multivariable cox regression was used to obtain the hazard ratio (HR). Results: The median age at operation was 43.5 months (IQR 24.0–73.0). Only three patients had patch-related adverse complications, and no difference existed among the three groups ( p = 0.763). After a median follow-up of 24.0 months (IQR 6.0–48.0), patients with a pericardium patch had a lower re-operation or restenosis rate compared with the other two groups (pericardium patch vs modified patch, HR = 0.30, 95% CI 0.12–0.77; pericardium patch vs artificial patch, HR = 0.33, 95% CI 0.13–0.82), even in the main subgroup and sensitivity analysis. Conclusions: In pediatric patients, the safety of autologous pericardium patch is acceptable, along with lower rates of middle-term re-operation or restenosis. Clinical Trial Registration: , number: ChiCTR2300067851.

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Section: Discussionmentioning

confidence: 67%

Effectiveness and Safety of Different Patch Materials for Supravalvar Aortic Stenosis (Middle-Term Outcomes)

Lang,

Lv,

Zhang

et al. 2024

Rev. Cardiovasc. Med.

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“…11 The Doty technique and Brom technique are seen as more preferred in SVAS surgery throughout recently published articles from Türkiye. 12 Koçyildirim et al found no significant difference between the two techniques in an SVAS article, in which single-patch and three-patch techniques were compared. 13 Bostan et al reported that reoperation was required for a patient who underwent single-patch surgery during the follow-up period.…”

Section: Discussionmentioning

confidence: 98%

Congenital heart defects and postoperative follow-up of patients with Williams syndrome as a single center experience and review of the cases from Türkiye

Orgun,

Tokel,

Erdoğan

et al. 2024

Turk J Pediatr

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Background. Cardiovascular system involvement is quite common and the leading cause of morbidity and mortality in patients with Williams syndrome (WS), most of whom need surgery. The present study aimed to provide a detailed evaluation of the features of surgical procedures and outcomes of patients with WS given as single-center experience, and additionally to make a detailed review from Türkiye. Materials and Methods. Thirty-five children with WS diagnosed between the years 1992 and 2021 were evaluated retrospectively including cardiovascular data, surgical treatment features, and outcomes. A total of six articles from Türkiye were evaluated. Results. A total of 35 patients with Williams Syndrome (24 male) with a median age of cardiologic diagnosis of 6 months (range, 2 days-6 years) were evaluated. The cardiac defects of the patients with WS were found as supravalvular aortic stenosis (SVAS) (n=30, 85%) and peripheral pulmonary stenosis (PPS) (n=21, 65%). Additional cardiac anomalies were seen in 71% patients. The rate of SVAS and PPS surgery in all patients with WS was 77.1%. The median surgical age of the patients was 2.5 years (range, 7 months-15.5 years). No patients died due to surgery. But one patient died because of ventricular tachycardia due to anesthesia at the beginning of angiography. A total of 138 (63% male) patients with WS were evaluated from the articles published in Türkiye. Of 138 patients, 64.4% had SVAS, 52.1% had PPS, and 39.8% had additional cardiac anomaly. The median follow-up period ranged from 17 months to 18 years, and six (4.3%) patients died in the early postoperative period. Conclusion. Cardiovascular system involvement is extremely common and is the leading cause of morbidity and mortality in patients with WS, often requiring surgical intervention. As seen in our study including 35 patients with WS and in publications from Türkiye, SVAS in patients with WS generally requires surgery, especially in the first year of life. PPS, on the other hand, requires surgery less frequently than SVAS, and pulmonary stenosis appears to decrease over time.

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“…After reviewing titles and abstracts, 41 citations remained for the full-text screening and 71 records were deleted due to irrelevance to our study. Finally, 27 studies (7, 8,11,14,[16][17][18][19][20][21][22][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] were included.…”

Section: Eligible Studiesmentioning

confidence: 99%

Assessment of three types of surgical procedures for supravalvar aortic stenosis: A systematic review and meta-analysis

Lang

Zhang

et al. 2022

Front. Cardiovasc. Med.

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ImportanceThe safety and efficacy of different surgical repairs of supravalvar aortic stenosis (SVAS) are inconsistent.ObjectiveTo compare the prognosis of single-, two- and three-patch repair for patients with SVAS.Data sourcesPubMed, EMBASE, Cochrane Library, Web of Science, and clinicaltrials.gov were searched until April 17, 2022.Study selectionStudy reported SVAS patients treated with single-, two- or three-patch repair.Data extraction and synthesisTwo reviewers independently extracted the data of study characteristics and clinical outcomes. Multiple pairwise and frequentist network meta-analyses were conducted. And a fixed-effect model was used when no heterogeneity existed.Main outcomes and measuresOutcomes included the rate of reintervention, aortic insufficiency, early mortality and late mortality, cardiopulmonary bypass (CPB) time, cross-clamping (CCP) time, and postoperative/ follow-up pressure gradient. Binary variables were evaluated by odds ratio (OR) and its 95% confidence interval (CI), while continuous variables were assessed by standardized mean difference (SMD) and its 95% CI.ResultsTwenty-seven retrospective cohort studies were included, comprising 1,162 patients, undergoing single-patch (46.6% of cases), two-patch (33.9%), and three-patch repair (19.4%). Two-patch method had a lower rate of reintervention compared with single-patch (OR = 0.47, 95 % CI 0.28–0.89), and three-patch (OR = 0.31, 95 % CI 0.15–0.64). This finding also applied to juvenile and non-Asian patients. Three-patch method had a lower rate of aortic insufficiency compared with single-patch (OR = 0.11, 95 % CI 0.01–0.63), and two-patch (OR = 0.11, 95 % CI 0.02–0.83). But this repair had the longest CCP time, which was significantly longer than that of single- (SMD = 0.76, 95 % CI 0.36–1.17) or two-patch repair (SMD = 0.61, 95 % CI 0.06–1.16). No significant difference was found in mortality and pressure gradient among three procedures.Conclusion and relevanceTwo-patch repair has the lowest reintervention rate and relatively reasonable operation time. Complex and severe SVAS is suggested to be treated with two-patch repair. Further prospective studies of a reasonable sample size will be required with a special focus on the use of different patch materials and surgeons' unique working experience.Systematic review registrationhttp://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022328146.

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Early and mid-term outcomes after surgical repair of congenital supravalvular aortic stenosis by Doty technique

Abstract: The Doty technique is an anatomically and technically effective surgical approach to treating SVAS.

Cited by 3 publications

References 0 publications

Effectiveness and Safety of Different Patch Materials for Supravalvar Aortic Stenosis (Middle-Term Outcomes)

Effectiveness and Safety of Different Patch Materials for Supravalvar Aortic Stenosis (Middle-Term Outcomes)

Congenital heart defects and postoperative follow-up of patients with Williams syndrome as a single center experience and review of the cases from Türkiye

Assessment of three types of surgical procedures for supravalvar aortic stenosis: A systematic review and meta-analysis

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