Surgical Correction for Congenital Valvular and Supravalvular Aortic Stenosis Associated with Coronary Ostial Stenosis in a Child

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Congenital valvular and supravalvular aortic stenosis associated with coronary ostial stenosis (n=1). Intervention: Single patch augmentation and aortic valvotomy vs. Pre-operative state. Primary outcome: Left ventricular outflow tract pressure gradient.

Masataka Satô; Yuji Hiramatsu; Hideyuki Kato; Muneaki Matsubara; Chiho Tokunaga; Shinya Kanemoto; Mio Noma; Masakazu Abe; Yuzuru Sakakibara

doi:10.4326/jjcvs.37.337

January 1, 2008Japanese Journal of Cardiovascular SurgeryOpen Access

Surgical Correction for Congenital Valvular and Supravalvular Aortic Stenosis Associated with Coronary Ostial Stenosis in a Child

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Why the study?

Does single patch augmentation and aortic valvotomy improve hemodynamics in a child with congenital bicuspid aortic valvular and supravalvular aortic stenosis associated with left coronary ostial stenosis?

Key Points

To describe an effective surgical technique for congenital valvular and supravalvular aortic stenosis complicated by severe left coronary ostial stenosis in a non-Williams syndrome pediatric patient.
Evaluated a 3-year-old boy presenting with a 90 mmHg left ventricular-aortic pressure gradient, severe left coronary ostial stenosis, and apical ischemic wall motion abnormalities.
Performed an aortic commissurotomy on a thickened bicuspid valve through an oblique aortotomy extended left-posteriorly toward the left coronary ostium.
Augmented both the narrowed supravalvular aorta and the left coronary ostium simultaneously using a single glutaraldehyde-treated autologous pericardial patch.
Relieved the severe left coronary ostial narrowing, leading to complete resolution of ischemic left ventricular wall motion abnormalities.
Alleviated the aortic outflow obstruction, significantly reducing the preoperative 90 mmHg left ventricular-to-aortic pressure gradient.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

Does single patch augmentation and aortic valvotomy improve hemodynamics in a child with congenital bicuspid aortic valvular and supravalvular aortic stenosis associated with left coronary ostial stenosis?

P

Population

A 4-year-old boy with congenital bicuspid aortic valvular and supravalvular stenosis complicated by left coronary ostial stenosis, without Williams syndrome, followed for 13 months post-surgery.

I

Intervention

Single patch augmentation (using glutaraldehyde-treated autologous pericardium) for supravalvular aortic stenosis and left coronary ostial stenosis, with concomitant aortic valvotomy.

O

Outcome

Reduction in left ventricular-aortic pressure gradient and improvement in ischemic left ventricular dysfunction.surrogate

Main Result

Absolute Event Rate: 10% vs 100%

Limitations

Careful long-term follow-up is necessary to monitor for morphological changes and potential restenosis of aortic stenosis.

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Implication

Single patch augmentation with concomitant aortic valvotomy successfully relieved supravalvular aortic stenosis and left coronary ostial stenosis in a child without Williams syndrome.

Abstract

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Discussion

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Cite This Study

Satô et al. (2008) conducted a case report in Congenital valvular and supravalvular aortic stenosis associated with coronary ostial stenosis (n=1). Single patch augmentation and aortic valvotomy vs. Pre-operative state was evaluated on Left ventricular outflow tract pressure gradient.

synapsesocial.com/papers/6a9e6d4c549d53af5cf6dce4 https://doi.org/10.4326/jjcvs.37.337

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Surgical Correction for Congenital Valvular and Supravalvular Aortic Stenosis Associated with Coronary Ostial Stenosis in a Child

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Surgical Correction for Congenital Valvular and Supravalvular Aortic Stenosis Associated with Coronary Ostial Stenosis in a Child

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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