Effectiveness and Safety of Different Patch Materials for Supravalvar Aortic Stenosis (Middle-Term Outcomes).

Autor:	Lang X; 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., Lv L; Department of Pediatric Cardiac Center, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China.; Department of Cardiac Surgery, Yunnan Fuwai Cardiovascular Hospital, 650102 Kunming, Yunnan, China., Zhang S; Department of Cardiac Surgery, Peking University People's Hospital, 100044 Beijing, China., Zhi A; Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, China.; Department of Radiology, Yunnan Fuwai Cardiovascular Hospital, 650102 Kunming, Yunnan, China., Wang C; Department of Cardiac Surgery, Yunnan Fuwai Cardiovascular Hospital, 650102 Kunming, Yunnan, China.; 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., Wang Q; Department of Pediatric Cardiac Center, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China.; Department of Cardiac Surgery, Yunnan Fuwai Cardiovascular Hospital, 650102 Kunming, Yunnan, China.
Jazyk:	angličtina
Zdroj:	Reviews in cardiovascular medicine [Rev Cardiovasc Med] 2024 Jan 09; Vol. 25 (1), pp. 14. Date of Electronic Publication: 2024 Jan 09 (Print Publication: 2024).
DOI:	10.31083/j.rcm2501014
Abstrakt:	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. Competing Interests: The authors declare no conflict of interest. (Copyright: © 2024 The Author(s). Published by IMR Press.)
Databáze:	MEDLINE
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