Key Points
- To identify clinical and hemodynamic predictors of subaortic stenosis recurrence and the occurrence and progression of concomitant aortic valve disease.
- Retrospective analysis of 51 patients with congenital subaortic stenosis followed at a tertiary congenital heart disease clinic between July 1982 and October 2009.
- Subaortic stenosis surgical correction was performed in 34 patients (66.7%), with recurrence observed in 18 patients (52.9%) and reoperation required in 8 patients (23.5%).
- Independent predictors of recurrence were shorter time from diagnosis to surgery (OR 0.98, 95% CI 0.96–1.00; P=0.04) and initial left ventricular outflow tract peak pressure gradient > 50 mm Hg (OR 2.63, 95% CI 1.52–4.53; P=0.05).
- Aortic valve disease was present in 37 patients (72.5%) at follow-up and was independently predicted by higher initial peak pressure gradient (OR 1.10, 95% CI 1.01–1.21; P=0.05) and higher left ventricular mass (OR 1.04, 95% CI 1.01–1.07; P=0.014).
Structured PICO
PPopulation51 patients with congenital subaortic stenosis (SAS) followed in a congenital heart disease clinic of a tertiary care hospital, mean age at diagnosis 15 years, 54.9% men.
OOutcomePredictors of SAS recurrence and aortic valve disease occurrence and progression
In patients with congenital subaortic stenosis, early surgery and high LVOT gradients predict recurrence, while aortic valve disease progression occurs independently of surgery.