Key result
Surgical repair of asymptomatic supravalvular aortic stenosis at age <2.0 years (HR 3.27) or >5.0 years (HR 2.87) significantly increased the risk of re-operation or restenosis compared to surgery at 2.0-5.0 years.
Why the study?
The appropriate age for surgical repair of asymptomatic congenital supravalvular aortic stenosis remains unknown.
Does the age at operation affect the risk of in-hospital death, ECMO requirement, and late re-operation or restenosis in asymptomatic pediatric patients with congenital supravalvular aortic stenosis?
Cohort (n=248)
Yes
Does the age at operation affect the risk of in-hospital death, ECMO requirement, and late re-operation or restenosis in asymptomatic pediatric patients with congenital supravalvular aortic stenosis?
In asymptomatic children with congenital supravalvular aortic stenosis, delaying surgical intervention until 2 to 5 years of age minimizes the risks of in-hospital mortality, ECMO requirement, and late re-operation or restenosis compared to surgery at <2 years or >5 years of age.
Background: The appropriate age for surgical repair of asymptomatic congenital supravalvular aortic stenosis (SVAS) is still unknown. The purpose of this research was to assess the safety and effectiveness of various operation ages when managing SVAS. Methods: Consecutive asymptomatic SVAS pediatric patients in the Beijing Fuwai and Yunnan Fuwai hospitals over a period of 18 years were retrospectively analyzed. Patients were classified as follows: age <2.0 years (y) (n = 84), 2.0-5.0 y (n = 72), and >5.0 y (n = 92). The primary safety endpoint was in-hospital death or extracorporeal membrane oxygenation (ECMO) needed. The primary effectiveness outcome was re-operation or restenosis during follow-up. To calculate the hazard ratios (HR), Cox regression with inverse probability of treatment weighted was utilized. The median follow-up was 25.5 months (IQR: 7.0-59.0). Compared with the age 2.0-5.0 y group, the age <2.0 y group and age >5.0 y group had a higher risk of re-operation or restenosis (age <2.0 y, HR = 3.27, 95% CI 1.25-8.60; age >5.0 y, HR = 2.87, 95% CI 1.19-6.91). Conclusions: Asymptomatic children with SVAS without other cardiovascular abnormalities should be considered for delayed surgical intervention until 2 years of age, and then surgery should be conducted as soon as possible. Children with severe symptoms should undergo surgery immediately, regardless of age. Clinical Trial Registration: ChiCTR2300067851, https://www.chictr.org.cn/showproj.html?proj=177491.
No takes yet. Share an insight, caveat, or question.
Lv et al. (2024) conducted a cohort in Asymptomatic congenital supravalvular aortic stenosis (n=248). Operation age <2.0 years vs. Operation age 2.0-5.0 years was evaluated on Re-operation or restenosis (HR 3.27, 95% CI 1.25-8.60, p=0.016). Surgical repair of asymptomatic supravalvular aortic stenosis at age <2.0 years (HR 3.27) or >5.0 years (HR 2.87) significantly increased the risk of re-operation or restenosis compared to surgery at 2.0-5.0 years.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: