Evaluation of Supravalvular Aortic Gradient Changes Following Inverted Y-Patch Repair

Objective: This study presents our single-institute experience regarding the patients who underwent surgical correction via inverted Y-patch repair with the diagnosis of supravalvular aortic stenosis. Method: A total of 16 patients who underwent inverted Y-patch (Doty) repair in our center between 2005 and 2019 were retrospectively analyzed. Complications, supravalvular residual gradient measurements, causes of re-operation were evaluated. Results: Patient population consisted of 9 males, 7 females with an overall mean age of 41.1816.14 months (range: 4 months to 19 years). Eight (50%) patients were diagnosed with Williams-Beuren syndrome and 3 (18.7%) with bicuspid aortic valve. Three (18.7%) patients had undergone simultaneous subaortic membrane resection and pulmonary patch plasty was performed in 2 (12.5%) patients. There was one (6.7%) inhospital death and no mortality was observed during follow-up. The mean follow-up time was 5.253.37 years. During this period, 2 (12.5%) patients required pulmonary balloon dilatation and one patient repeated Doty repair and aortic valve commissurotomy two years after the initial surgery. Thereafter the same patient needed aortic homograft valve replacement and Doty repair for the third time due to severe aortic insufficiency and suprvalvular aortic stenosis. Conclusion: Inverted Y-patch repair provides satisfactory results, acceptable reoperation risk, and good overall survival.