Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair
Yıl: 2020 Cilt: 10 Sayı: 2 Sayfa Aralığı: 120 - 126 Metin Dili: İngilizce DOI: 10.5222/buchd.2020.88155 İndeks Tarihi: 09-06-2021
Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair
Öz: Objective: This study presents our single-institute experience regarding the patients who underwent sur-gical 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 41.18±16.14 months (range: 4 months to 19 years). Eight (50%) patients were diagnosed with Williams-Beuren syndro-me and 3 (18.7%) with bicuspid aortic valve. Three (18.7%) patients had undergone simultaneous subaor-tic 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 5.25±3.37 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.
Anahtar Kelime: Ters Y Şeklinde Yama Tamiri Sonrası Supravalvülar Aort Gradient Değişiminin Değerlendirilmesi
Öz: Amaç: Bu çalışma, supravalvüler aort darlığı tanısı ile ters Y-yama onarımı ile cerrahi düzeltme yapılan hastalarla ilgili tek enstitü deneyimimizi sunmaktadır. Yöntem: 2005-2019 yılları arasında merkezimizde Y-yama (Doty) onarımı yapılan 16 hasta retrospektif olarak incelendi. Komplikasyonlar, supravalvüler rezidüel gradyan ölçümleri, tekrar ameliyat nedenleri değerlendirildi. Bulgular: Hastaların 9’u erkek, 7’si kadın olup ortalama yaş 41,18±16,14 aydı (aralık: 4 ay - 19 yıl). Sekiz (%50) hastaya Williams-Beuren sendromu ve 3 (%18,7) hastaya biküspit aort kapağı tanısı konuldu. Üç hastaya (%18,7) eşzamanlı subaortik membran rezeksiyonu ve 2’sine (%12,5) pulmoner yama plasti uygu-landı. Bir (%6,7) hastane ölümü vardı ve takipte mortalite gözlenmedi. Ortalama takip süresi 5,25±3,37 yıl idi. Takipte, 2 (%12,5) hastada ilk işlemden iki yıl sonra pulmoner arter balon dilatasyonu ve bir hastada tekrarlanan Doty onarımı ve aort kapak komissürotomisi gereksinimi oldu. Daha sonra aynı hastada üçün-cü kez aortik aort yetersizliği ve suprvalvüler aort darlığı sebepleriyle aortik homogreft kapak replasmanı ve yeniden Doty onarımı gerekti. Sonuç: Ters Y-yama onarımı, tatmin edici sonuçlar, kabul edilebilir yeniden operasyon riski ve iyi bir genel sağkalım sağlar.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Kouchoukos NT. “Kirklin/Barratt-Boyes’ cardiac surgery: morphology, diagnostic criteria, natural history, techniques, results, and indications”. 3rd edition. Philadelphia (PA): Churchill Livingstone; 2003. p. 1265-313.
- 2. Kaushal S, Backer CL, Patel S, Gossett JG, Mavroudis C. Midterm outcomes in supravalvular aortic stenosis demonstrate the superiority of multisinus aortoplasty. Ann Thorac Surg. 2010;89:1371-7. https://doi.org/10.1016/j.athoracsur.2010.02.019
- 3. Mitchell MB, Goldberg SP. Supravalvar aortic stenosis in infancy. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2011;14:85-91. https://doi.org/10.1053/j.pcsu.2011.01.013
- 4. Stamm C, Friehs I, Ho SY, Moran AM, Jonas RA, del Nido PJ. Congenital supravalvar aortic stenosis: a simple lesion? Eur J Cardiothorac Surg. 2001;19:195-202. https://doi.org/10.1016/S1010-7940(00)00647-3
- 5. Mongé MC, Eltayeb OM, Costello JM, Johnson JT, Popescu AR, Rigsby CK, et al. Brom aortoplasty for supravalvular aortic stenosis. World J Pediatr Congenit Heart Surg. 2018;9(2):139-46. https://doi.org/10.1177/2150135118754520
- 6. Fricke TA, d’Udekem Y, Brizard CP, Wheaton G, Weintraub RG, Konstantinov IE. Surgical repair of supravalvular aortic stenosis in children with Williams syndrome: a 30-year experience. Ann Thorac Surg. 2015;99:1335-41. https://doi.org/10.1016/j.athoracsur.2014.11.044
- 7. Deo SV, Burkhart HM, Schaff HV, Li Z, Stensrud PE, Olson TM, et al. Late outcomes for surgical repair of supravalvar aortic stenosis. Ann Thorac Surg. 2012;94(3):854-9. https://doi.org/10.1016/j.athoracsur.2012.04.022
- 8. Scott DJ, Campbell DN, Clarke DR, Goldberg SP, Karlin DR, Mitchell MB. Twenty-year surgical experience with congenital supravalvar aortic stenosis. Ann Thorac Surg. 2009;87:1501-8. https://doi.org/10.1016/j.athoracsur.2009.01.070
- 9. Metton O, Ben Ali W, Calvaruso D, Bonnet D, Sidi D, Raisky O, et al. Surgical management of supravalvular aortic stenosis: does Brom three-patch technique provide superior results? Ann Thorac Surg. 2009;88(2):588-93. https://doi.org/10.1016/j.athoracsur.2009.04.107
- 10. McGoon DC, Mankin HT, Vlad P, Kirklin JW. The surgical treatment of supravalvular aortic stenosis. J Thorac Cardiovasc Surg. 1961;41(1):125-33.
- 11. Doty DB, Polansky DB, Jenson CB. Supravalvular aortic stenosis. Repair by extended aortoplasty. J Thorac Cardiovasc Surg. 1977;74(3):362-71. https://doi.org/10.1016/S0022-5223(19)41350-0
- 12. Brom AG. Obstruction of the left ventricular outflow tract. In: Khonsari S, editor. Cardiac Surgery: Safeguards and Pitfalls in Operative Technique, 1st edition. Rockville: Aspen Publishers; 1988. p. 276-80.
- 13. Kramer P, Absi D, Hetzer R, Photiadis J, Berger F, Alexi- Meskishvili V. Outcome of surgical correction of congenital supravalvular aortic stenosis with two- and three-sinus reconstruction techniques. Ann Thorac Surg. 2014;97:634- 40. https://doi.org/10.1016/j.athoracsur.2013.09.083
- 14. Padalino MA, Frigo AC, Comisso M, Kostolny M, Omeje I, Schreiber C, et al. Early and late outcomes after surgical repair of congenital supravalvular aortic stenosis: a European Congenital Heart Surgeons Association multicentric study. Eur J Cardiothorac Surg. 2017;52(4):789-97. https://doi.org/10.1093/ejcts/ezx245
- 15. Donald JS, Fricke TA, Griffiths S, Konstantinov IE. Surgical correction of congenital supravalvular aortic stenosis. Oper Tech Thorac Cardiovasc Surg. 2016;21:202-10. https://doi.org/10.1053/j.optechstcvs.2017.05.003
- 16. Liu H, Gao B, Sun Q, Du X, Pan Y, Zhu Z, et al. Surgical strategies and outcomes of congenital supravalvular aortic stenosis. J Card Surg. 2017;32:652-8. https://doi.org/10.1111/jocs.13213
- 17. Roemers R, Kluin J, de Heer F, Arrigoni S, Bökenkamp R, van Melle J, et al. Surgical correction of supravalvar aortic stenosis: 52 years’ experience. World J Pediatr Congenit Heart Surg. 2018;9(2):131-8. https://doi.org/10.1177/2150135117745004
- 18. Kari FA, Kroll J, Kiss J, Hess C, Stiller B, Siepe M, et al. Progression of aortic regurgitation after different repair techniques for congenital aortic valve stenosis. Pediatr Cardiol. 2016;37:84-9. https://doi.org/10.1007/s00246-015-1243-0
| APA | akkaya g, Bilen Ç, Tuncer O, Atay Y (2020). Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair. , 120 - 126. 10.5222/buchd.2020.88155 |
| Chicago | akkaya gokmen,Bilen Çağatay,Tuncer Osman Nuri,Atay Yuksel Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair. (2020): 120 - 126. 10.5222/buchd.2020.88155 |
| MLA | akkaya gokmen,Bilen Çağatay,Tuncer Osman Nuri,Atay Yuksel Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair. , 2020, ss.120 - 126. 10.5222/buchd.2020.88155 |
| AMA | akkaya g,Bilen Ç,Tuncer O,Atay Y Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair. . 2020; 120 - 126. 10.5222/buchd.2020.88155 |
| Vancouver | akkaya g,Bilen Ç,Tuncer O,Atay Y Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair. . 2020; 120 - 126. 10.5222/buchd.2020.88155 |
| IEEE | akkaya g,Bilen Ç,Tuncer O,Atay Y "Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair." , ss.120 - 126, 2020. 10.5222/buchd.2020.88155 |
| ISNAD | akkaya, gokmen vd. "Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair". (2020), 120-126. https://doi.org/10.5222/buchd.2020.88155 |
| APA | akkaya g, Bilen Ç, Tuncer O, Atay Y (2020). Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair. İzmir Dr. Behçet Uz Çocuk Hastanesi Dergisi, 10(2), 120 - 126. 10.5222/buchd.2020.88155 |
| Chicago | akkaya gokmen,Bilen Çağatay,Tuncer Osman Nuri,Atay Yuksel Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair. İzmir Dr. Behçet Uz Çocuk Hastanesi Dergisi 10, no.2 (2020): 120 - 126. 10.5222/buchd.2020.88155 |
| MLA | akkaya gokmen,Bilen Çağatay,Tuncer Osman Nuri,Atay Yuksel Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair. İzmir Dr. Behçet Uz Çocuk Hastanesi Dergisi, vol.10, no.2, 2020, ss.120 - 126. 10.5222/buchd.2020.88155 |
| AMA | akkaya g,Bilen Ç,Tuncer O,Atay Y Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair. İzmir Dr. Behçet Uz Çocuk Hastanesi Dergisi. 2020; 10(2): 120 - 126. 10.5222/buchd.2020.88155 |
| Vancouver | akkaya g,Bilen Ç,Tuncer O,Atay Y Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair. İzmir Dr. Behçet Uz Çocuk Hastanesi Dergisi. 2020; 10(2): 120 - 126. 10.5222/buchd.2020.88155 |
| IEEE | akkaya g,Bilen Ç,Tuncer O,Atay Y "Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair." İzmir Dr. Behçet Uz Çocuk Hastanesi Dergisi, 10, ss.120 - 126, 2020. 10.5222/buchd.2020.88155 |
| ISNAD | akkaya, gokmen vd. "Evaluation of Supravalvular Changes in Aortic ID Gradient Following Inverted Y-Patch Repair". İzmir Dr. Behçet Uz Çocuk Hastanesi Dergisi 10/2 (2020), 120-126. https://doi.org/10.5222/buchd.2020.88155 |
