Clinical risk factors for early adverse cardiovascular events after surgical correction of supravalvar aortic stenosis: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Simeng ¹ , WEI Caiyi ² , LÜ Lizhi ³ , PENG Bo ⁴ , XIA Jianming ⁵ , WANG Qiang ³ , YAN Jun ⁴ ,  SHI Yi ¹

1. Department of Cardiac Surgery, Peking University People’s Hospital, Beijing, 100044, P. R. China;
2. School of Basic Medical Sciences, Peking University, Beijing, 100191, P. R. China;
3. Center for Pediatric Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, P. R. China;
4. Department of Cardiac Surgery, National Center for Cardiovascular Diseases and Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, P. R. China;
5. Department of Cardiac Surgery, Fuwai Yunnan Cardiovascular Hospital, Kunming, 650102, P. R. China;

Corresponding author：

SHI Yi, Email: 13522720660@126.com

Keywords：

Congenital heart disease; supravalvar aortic stenosis; surgical treatment; adverse cardiovascular events; risk factors

DOI：

10.7507/1007-4848.202403010

Video：

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Objective To identify clinical risk factors for early major adverse cardiovascular events (MACEs) following surgical correction of supravalvar aortic stenosis (SVAS). Methods Patients who underwent SVAS surgical correction between 2002 and 2019 in Beijing and Yunnan Fuwai Cardiovascular Hospitals were included. The patients were divided into a MACEs group and a non-MACEs group based on whether MACEs concurring during postoperative hospitalization or within 30 days following surgical correction for SVAS. Their preoperative, intraoperative, and postoperative clinical data were collected for multivariate logistic regression. Results This study included 302 patients. There were 199 males and 103 females, with a median age of 63.0 (29.2, 131.2) months. The incidence of early postoperative MACEs was 7.0% (21/302). The multivariate logistic regression model identified independent risk factors for early postoperative MACEs, including ICU duration (OR=1.01, 95%CI 1.00-1.01, P=0.032), intraoperative cardiopulmonary bypass (CPB) time (OR=1.02, 95%CI 1.01-1.04, P=0.014), aortic annulus diameter (OR=0.65, 95%CI 0.43-0.97, P=0.035), aortic sinus inner diameter (OR=0.75, 95%CI 0.57-0.98, P=0.037), and diameter of the stenosis (OR=0.56, 95%CI 0.35-0.90, P=0.016). Conclusion The independent risk factors for early postoperative MACEs include ICU duration, intraoperative CPB time, aortic annulus diameter, aortic sinus inner diameter, and diameter of the stenosis. Early identification of high-risk populations for MACEs is beneficial for the development of clinical treatment strategies.

Citation： ZHANG Simeng, WEI Caiyi, LÜ Lizhi, PENG Bo, XIA Jianming, WANG Qiang, YAN Jun, SHI Yi. Clinical risk factors for early adverse cardiovascular events after surgical correction of supravalvar aortic stenosis: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(10): 1448-1454. doi: 10.7507/1007-4848.202403010 Copy

1.	Lev M. The pathologic anatomy of cardiac complexes associated with transposition of arterial trunks. Lab Invest, 1953, 2(4): 296-311.
2.	Lv L, Lang X, Zhang S, et al. Assessment of three types of surgical procedures for supravalvar aortic stenosis: A systematic review and meta-analysis. Front Cardiovasc Med, 2022, 9: 987522.
3.	Padalino MA, Frigo AC, Comisso M, 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): 789-797.
4.	Deo SV, Burkhart HM, Schaff HV, et al. Late outcomes for surgical repair of supravalvar aortic stenosis. Ann Thorac Surg, 2012, 94(3): 854-859.
5.	Bird LM, Billman GF, Lacro RV, et al. Sudden death in Williams syndrome: Report of ten cases. J Pediatr, 1996, 129(6): 926-931.
6.	Collins RT. Clinical significance of prolonged QTc interval in Williams syndrome. Am J Cardiol, 2011, 108(3): 471-473.
7.	Kaushal S, Backer CL, Patel S, et al. Midterm outcomes in supravalvular aortic stenosis demonstrate the superiority of multisinus aortoplasty. Ann Thorac Surg, 2010, 89(5): 1371-1377.
8.	Metton O, Ben Ali W, Calvaruso D, et al. Surgical management of supravalvular aortic stenosis: Does Brom three-patch technique provide superior results? Ann Thorac Surg, 2009, 88(2): 588-593.
9.	Keating MT. Genetic approaches to cardiovascular disease. Supravalvular aortic stenosis, Williams syndrome, and long-QT syndrome. Circulation, 1995, 92(1): 142-147.
10.	Liu H, Gao B, Sun Q, et al. Surgical strategies and outcomes of congenital supravalvular aortic stenosis. J Card Surg, 2017, 32(10): 652-658.
11.	Brown JW, Ruzmetov M, Vijay P, et al. Surgical repair of congenital supravalvular aortic stenosis in children. Eur J Cardiothorac Surg, 2002, 21(1): 50-56.
12.	Imamura M, Prodhan P, Dossey AM, et al. Reoperation after supravalvular aortic stenosis repair. Ann Thorac Surg, 2010, 90(6): 2016-2022.
13.	van Son JA, Danielson GK, Puga FJ, et al. Supravalvular aortic stenosis. Long-term results of surgical treatment. J Thorac Cardiovasc Surg, 1994, 107(1): 103-114.
14.	Meccanici F, Notenboom ML, Meijssen J, et al. Long-term surgical outcomes of congenital supravalvular aortic stenosis: A systematic review, meta-analysis and microsimulation study. Eur J Cardiothorac Surg, 2024, 65(1): ezad360.
15.	Wu FY, Mondal A, Del Nido PJ, et al. Long-term surgical prognosis of primary supravalvular aortic stenosis repair. Ann Thorac Surg, 2019, 108(4): 1202-1209.
16.	Peng B, Wang Q. Avoidance of malignant arrhythmia caused by displacement of the right coronary artery ostium in surgical correction of supravalvular aortic stenosis. J Int Med Res, 2019, 47(11): 5702-5710.
17.	Lv L, Lang X, Zhang S, et al. Clinical results of a modified Doty's technique for supravalvular aortic stenosis. J Clin Med, 2023, 12(5): 1731.

1. Lev M. The pathologic anatomy of cardiac complexes associated with transposition of arterial trunks. Lab Invest, 1953, 2(4): 296-311.
2. Lv L, Lang X, Zhang S, et al. Assessment of three types of surgical procedures for supravalvar aortic stenosis: A systematic review and meta-analysis. Front Cardiovasc Med, 2022, 9: 987522.
3. Padalino MA, Frigo AC, Comisso M, 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): 789-797.
4. Deo SV, Burkhart HM, Schaff HV, et al. Late outcomes for surgical repair of supravalvar aortic stenosis. Ann Thorac Surg, 2012, 94(3): 854-859.
5. Bird LM, Billman GF, Lacro RV, et al. Sudden death in Williams syndrome: Report of ten cases. J Pediatr, 1996, 129(6): 926-931.
6. Collins RT. Clinical significance of prolonged QTc interval in Williams syndrome. Am J Cardiol, 2011, 108(3): 471-473.
7. Kaushal S, Backer CL, Patel S, et al. Midterm outcomes in supravalvular aortic stenosis demonstrate the superiority of multisinus aortoplasty. Ann Thorac Surg, 2010, 89(5): 1371-1377.
8. Metton O, Ben Ali W, Calvaruso D, et al. Surgical management of supravalvular aortic stenosis: Does Brom three-patch technique provide superior results? Ann Thorac Surg, 2009, 88(2): 588-593.
9. Keating MT. Genetic approaches to cardiovascular disease. Supravalvular aortic stenosis, Williams syndrome, and long-QT syndrome. Circulation, 1995, 92(1): 142-147.
10. Liu H, Gao B, Sun Q, et al. Surgical strategies and outcomes of congenital supravalvular aortic stenosis. J Card Surg, 2017, 32(10): 652-658.
11. Brown JW, Ruzmetov M, Vijay P, et al. Surgical repair of congenital supravalvular aortic stenosis in children. Eur J Cardiothorac Surg, 2002, 21(1): 50-56.
12. Imamura M, Prodhan P, Dossey AM, et al. Reoperation after supravalvular aortic stenosis repair. Ann Thorac Surg, 2010, 90(6): 2016-2022.
13. van Son JA, Danielson GK, Puga FJ, et al. Supravalvular aortic stenosis. Long-term results of surgical treatment. J Thorac Cardiovasc Surg, 1994, 107(1): 103-114.
14. Meccanici F, Notenboom ML, Meijssen J, et al. Long-term surgical outcomes of congenital supravalvular aortic stenosis: A systematic review, meta-analysis and microsimulation study. Eur J Cardiothorac Surg, 2024, 65(1): ezad360.
15. Wu FY, Mondal A, Del Nido PJ, et al. Long-term surgical prognosis of primary supravalvular aortic stenosis repair. Ann Thorac Surg, 2019, 108(4): 1202-1209.
16. Peng B, Wang Q. Avoidance of malignant arrhythmia caused by displacement of the right coronary artery ostium in surgical correction of supravalvular aortic stenosis. J Int Med Res, 2019, 47(11): 5702-5710.
17. Lv L, Lang X, Zhang S, et al. Clinical results of a modified Doty's technique for supravalvular aortic stenosis. J Clin Med, 2023, 12(5): 1731.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical risk factors for early adverse cardiovascular events after surgical correction of supravalvar aortic stenosis: A retrospective cohort study

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