Key result
Doty technique linked to ~81% lower residual stenosis vs McGoon in congenital SVAS.
Why the study?
The comparative outcomes of the Doty and McGoon surgical techniques for congenital supravalvular aortic stenosis were not well established.
Does the Doty technique improve outcomes compared to the McGoon technique in patients undergoing surgical reconstruction for congenital supravalvular aortic stenosis?
Cohort (n=29)
No
Does the Doty technique improve outcomes compared to the McGoon technique in patients undergoing surgical reconstruction for congenital supravalvular aortic stenosis?
Absolute Event Rate: 6.7% vs 35.7%
p-value: p=0.05
The Doty technique may provide better relief of supravalvular aortic stenosis with lower residual stenosis and re-operation rates compared to the McGoon technique.
Small single-center cohort leaves optimal repair technique for supravalvular aortic stenosis open; multicenter prospective comparisons needed.
BACKGROUND: We aimed to compare the results of two surgical methods for the treatment of congenital supravalvular aortic stenosis. METHODS: From May 2004 to January 2020, 29 patients underwent surgical repair for supravalvular aportic stenosis in a single centre. The perioperative evaluation of the patients was retrospectively reviewed. RESULTS: Fifteen (51.7%) and 14 (48.2%) patients were treated with the Doty and the McGoon methods, respectively. The median age of our cohort was 4.5 (3.0-9.9) years. Ten (34.5%) patients had Williams-Beuren syndrome, and pulmonary stenosis was observed in 12 (41.3%) patients. The median follow-up time was 2.5 (0.7-7.3) years. On follow-up, five patients had residual stenosis with the McGoon technique and one with the Doty technique (p = 0.05). One patient died early in the post-operative period in the Doty group, and three patients were re-operated on due to restenosis in the McGoon group. Freedom from re-operation in the Doty group at 1, 3, 5, and 10 years was 100%. In the McGoon group, freedom from re-operation rates at the 1-, 3-, and 7-year follow-up were 100, 88.9, and 44.4%, respectively (p = 0.08). CONCLUSION: Our results with both surgical techniques suggest that supravalvular aortic stenosis can be treated with good results. The Doty method provided better relief for the supravalvular aortic segment, considering the residual stenosis and the re-operation rates.
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Biçer et al. (2021) conducted a cohort in congenital supravalvular aortic stenosis (n=29). Doty technique vs. McGoon technique was evaluated on Residual stenosis (p=0.05). The Doty technique was associated with lower rates of residual stenosis compared to the McGoon technique (6.7% vs 35.7%; p=0.05) in patients with congenital supravalvular aortic stenosis.
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