Long-Term Outcomes After Supravalvar Aortic Stenosis Repair: Impact of Residual Haemodynamics on Reintervention
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: Surgical repair of supravalvar aortic stenosis (SVAS) provides excellent early outcomes; however, late reintervention remains common. The determinants of left ventricular outflow tract (LVOT) failure, particularly the role of residual haemodynamics, remain incompletely defined. We sought to identify predictors of LVOT reintervention in a contemporary cohort. METHODS: A retrospective study of consecutive patients aged <18 years undergoing SVAS repair between 2005 and 2024 was performed. Primary end-points were overall survival and freedom from LVOT reintervention. Survival and freedom from reintervention were assessed using Kaplan-Meier analysis. Multivariable Cox regression was used to identify independent predictors of LVOT reintervention. RESULTS: Seventy-seven patients underwent repair at a median age of 3 (1-8) years, with median follow-up of 9.3 (6-14) years. There was no early or late mortality; 19 patients (25%) required reintervention, including 16 (21%) LVOT-related procedures. Freedom from LVOT reintervention was 74% at 10 years and 71% at 15-20 years. Discharge LVOT velocity >3 metres per second (m/s) was independently associated with LVOT reintervention (hazard ratio [HR] 11.66, 95% confidence interval [CI] 3.56-38.18; P < .001). Younger age was also independently associated with increased risk (HR per year 0.74, 95% CI, 0.59-0.94; P = .013) for LVOT reintervention. Coronary abnormalities were documented in 17% of patients, with one early coronary reintervention. CONCLUSIONS: Surgical repair of supravalvar aortic stenosis is associated with excellent long-term survival. Residual discharge velocity emerged as an independent predictor of late LVOT reintervention, supporting the importance of achieving optimal haemodynamic relief at the index operation and structured lifelong surveillance.
Institutions: Great Ormond Street Hospital, University College London
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,258
OpenAlex ID: W7203636465