[Epidemiological, clinical and echographic profile of patients operated for subvalvular aortic stenosis in the region of Sfax (Tunisia) and factors associated with postoperative recurrence: an observational study].

Autor: Bahloul A; Service de Cardiologie, Centre Hospitalo-Universitaire Hèdi Chaker, Sfax, Tunisie., Charfeddine S; Service de Cardiologie, Centre Hospitalo-Universitaire Hèdi Chaker, Sfax, Tunisie., Abid D; Service de Cardiologie, Centre Hospitalo-Universitaire Hèdi Chaker, Sfax, Tunisie., Hammami R; Service de Cardiologie, Centre Hospitalo-Universitaire Hèdi Chaker, Sfax, Tunisie., Abid L; Service de Cardiologie, Centre Hospitalo-Universitaire Hèdi Chaker, Sfax, Tunisie., Kammoun S; Service de Cardiologie, Centre Hospitalo-Universitaire Hèdi Chaker, Sfax, Tunisie.
Jazyk: francouzština
Zdroj: The Pan African medical journal [Pan Afr Med J] 2022 Apr 08; Vol. 41, pp. 288. Date of Electronic Publication: 2022 Apr 08 (Print Publication: 2022).
DOI: 10.11604/pamj.2022.41.288.28561
Abstrakt: Subvalvular aortic stenosis is difficult to manage due to the evolutionary unpredictability of stenosis and a high recurrence rate after surgical treatment. The purpose of this study is to describe the profile of patients undergoing surgery for the treatment of aortic subvalvular stenosis and to investigate factors associated with post-operative recurrence of the subaortic obstacle. We conducted an observational study of all patients operated for subvalvular aortic stenosis, whose data were collected in the Department of Cardiology of the Sfax University Hospital between January 2010 and December 2020. The study involved 28 patients, with predominance of male sex (64.29%, n=18). At diagnosis, the mean age was 6.82 (±4.84) years and 19 patients (67.85%) had symptoms. On echocardiography, maximal subaortic gradient ≥50 mmHg was found in 23 patients (82.14%). Cardiovascular malformations associated with subvalvular stenosis were found in 16 patients (57.14%). The average age of patients at the time of surgery was 10.43 (±7.08) years. Subaortic membrane resection was the most commonly used technique (46.4%, n=13). It was associated with septal myomectomy in 8 patients (28.6%). Postoperative mortality rate was zero. Residual gradient ≥30 mmHg was reported in 8 patients (28.6%) after surgery. Recurrences were observed in 7 patients (25%) of whom 6 underwent reintervention. In multivariate analysis, only postoperative residual gradient was significantly associated with recurrence (p=0.030, OR=33.785, 95% CI: 1.398-816.754). Despite old age at diagnosis and surgery, favorable short-term outcomes were reported, but recurrences were frequent in the long term. This highlights the role of regular, perioperative and postoperative, clinical and echographic monitoring of these patients.
Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts.
(Copyright: Amine Bahloul et al.)
Databáze: MEDLINE
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