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The Annals of Thoracic Surgery, Vol 51, 1031-1039, Copyright © 1991 by The Society of Thoracic Surgeons
BK Sharma, H Fujiwara, GL Hallman, DA Ott, GJ Reul and DA Cooley
Between February 1960 and August 1989, 73 consecutive patients underwent
surgical correction for supravalvar aortic stenosis (SVAS) at the Texas
Heart Institute. There were 43 male (59%) and 30 female patients (41%)
ranging in age from 5 days to 27 years (mean age, 12 years).
Preoperatively, 8 patients were in New York Heart Association functional
class I, 43 in class II, 18 in class III, and 4 in class IV. Of the 73
patients, 62 had localized SVAS and 11 (15%), diffuse SVAS. For all
procedures, patients were placed on cardiopulmonary bypass. Those with
localized SVAS were successfully treated with patch aortoplasty, whereas
those with diffuse SVAS required either an apicoaortic conduit or extensive
end-arterectomy with extended patch aortoplasty. There were eight early
deaths (less than or equal to 30 days postoperatively) (11%) and four late
deaths (greater than 30 days postoperatively) (6%) in a follow-up period
ranging from 2 months to 28 years. Sixteen patients (25%) underwent one or
more additional operations in the follow-up period. Postoperatively, there
were 44 patients in New York Heart Association functional class I and 17 in
class II. Preoperative functional class III and class IV (p less than
0.0005), diffuse SVAS (p = 0.05), and the presence of associated congenital
defects (p less than 0.01) were important determinants of death.
ARTICLES
Supravalvar aortic stenosis: a 29-year review of surgical experience
Texas Heart Institute, Houston 77225-0345.
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