Echocardiographic follow-up of children with isolated discrete subaortic stenosis
| Autor: | Tevfik Demir, Levent Saltik, Gülay Ahunbay, Gürkan Çetin, Alper Güzeltaş, Kadir Babaoğlu, Ayşe Güler Eroğlu, Funda Oztunc |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Aortic Valve Insufficiency Internal medicine medicine Discrete Subaortic Stenosis Humans Severe stenosis Child Echocardiography Doppler Pulsed Medical treatment business.industry Incidence (epidemiology) Infant Newborn Infant Mean age Vascular surgery medicine.disease Surgery Cardiac surgery Echocardiography Doppler Color Stenosis Child Preschool Pediatrics Perinatology and Child Health Cardiology Disease Progression Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Pediatric cardiology. 27(6) |
| ISSN: | 0172-0643 |
| Popis: | This study evaluates the progression of stenosis, onset and progression of aortic regurgitation (AR), and the results of surgical outcomes in children with isolated discrete subaortic stenosis (SAS). The medical records of 108 patients (mean age, 5.5 +/- 3.8 years; range, 3 days to 18 years) with isolated discrete SAS were reviewed. Patients with lesions other than AR were excluded. Very mild stenosis was defined as Doppler peak systolic instantaneous gradient (PSIG) less than 25 mmHg, mild stenosis as 25-49 mmHg, moderate stenosis as 50-75 mmHg, and severe stenosis as more than 75 mmHg. Seventy-eight of 108 patients were followed for 2 months to 14 years (mean, 4.8 +/- 3.7 years; median, 5 years) with medical treatment alone. In these patients, the mean PSIG at last echocardiogram was higher than the mean PSIG at initial echocardiogram (39 +/- 19 vs 31 +/- 12 mmHg, respectively; p < 0.001). Among 24 patients with very mild stenosis at initial echocardiogram, 10 had mild and 2 had moderate stenosis after a mean period of 5.6 years. Among 46 patients with mild stenosis at initial echocardiogram, 11 had moderate and 5 had severe stenosis after a mean period of 4.1 years. Only 1 patient among the 8 patients with moderate stenosis at initial echocardiogram had severe stenosis after a mean period of 2.7 years. Thirty-nine patients (50%) had AR (13% trivial, 33% mild, and 4% moderate) at initial echocardiogram. After a mean period of 4.8 years, 77% of the patients had AR (10% trivial, 53% mild, 9% mild-moderate, and 5% moderate). Twenty-four patients underwent surgery. Preoperatively, mean Doppler PSIG and AR incidence were 64 +/- 17 mmHg and 91% (22/24), respectively. The mean Doppler PSIG was 30 +/- 19 mmHg and AR was present in all of the patients a mean period of 4.1 years after surgery. Two patients underwent reoperation for recurrent SAS and AR. Patients with very mild or mild stenosis may be followed noninvasively every year. One patient of the 8 patients with moderate stenosis progressed to severe stenosis, and moderate AR developed in 2 patients after a mean of 2.7 years. We recommend that patients with moderate stenosis undergo careful evaluation to determine whether surgery is necessary due to the severity of stenosis and AR. |
| Databáze: | OpenAIRE |
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