IMR Press / RCM / Volume 25 / Issue 1 / DOI: 10.31083/j.rcm2501014
Open Access Original Research
Effectiveness and Safety of Different Patch Materials for Supravalvar Aortic Stenosis (Middle-Term Outcomes)
Xinyue Lang1,†Lizhi Lv2,3,†Simeng Zhang4Aihua Zhi5,6Cheng Wang3,7,*Qiang Wang2,3,*
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1 Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, The National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 102300 Beijing, China
2 Department of Pediatric Cardiac Center, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China
3 Department of Cardiac Surgery, Yunnan Fuwai Cardiovascular Hospital, 650102 Kunming, Yunnan, China
4 Department of Cardiac Surgery, Peking University People’s Hospital, 100044 Beijing, China
5 Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, China
6 Department of Radiology, Yunnan Fuwai Cardiovascular Hospital, 650102 Kunming, Yunnan, China
7 Center for Pediatric Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, China
*Correspondence: zdwangcheng@163.com (Cheng Wang); wq.cory@163.com (Qiang Wang)
These authors contributed equally.
Rev. Cardiovasc. Med. 2024, 25(1), 14; https://doi.org/10.31083/j.rcm2501014
Submitted: 7 June 2023 | Revised: 28 August 2023 | Accepted: 1 September 2023 | Published: 9 January 2024
(This article belongs to the Section Heart Diseases)
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: To determine the effectiveness and safety of different patch materials in the treatment of pediatric patients with congenital supravalvular aortic stenosis (SVAS). Methods: 218 consecutive SVAS patients (age <14 years) who underwent surgery from Beijing Fuwai and Yunnan Fuwai hospital between 2002 and 2020 were included. Patients were divided into the pericardium patch group (133 (61.0%)), modified patch group (43 (19.7%)) and artificial patch group (42 (19.3%)). The primary safety endpoint was patch-related adverse complications (post-operation patch hemorrhage or aortic sinus aneurysm at 2-year follow-up). The primary effectiveness outcome was the re-operation or restenosis at 2-year follow-up. Multivariable cox regression was used to obtain the hazard ratio (HR). Results: The median age at operation was 43.5 months (IQR 24.0–73.0). Only three patients had patch-related adverse complications, and no difference existed among the three groups (p = 0.763). After a median follow-up of 24.0 months (IQR 6.0–48.0), patients with a pericardium patch had a lower re-operation or restenosis rate compared with the other two groups (pericardium patch vs modified patch, HR = 0.30, 95% CI 0.12–0.77; pericardium patch vs artificial patch, HR = 0.33, 95% CI 0.13–0.82), even in the main subgroup and sensitivity analysis. Conclusions: In pediatric patients, the safety of autologous pericardium patch is acceptable, along with lower rates of middle-term re-operation or restenosis. Clinical Trial Registration: http://www.chictr.org.cn, number: ChiCTR2300067851.

Keywords
supravalvular aortic stenosis
surgical repair
pericardium patch
modified patch
artificial patch
Funding
2022YFC2503400/National Key Research and Development Program
202302AA310045/Yunnan Provincial Clinical Research Center for Cardiovascular Diseases
Figures
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