Preoperative Factors That Predict Recurrence after Repair of Discrete Subaortic Stenosis

Abstract Background Several factors predict reintervention for subaortic stenosis (SubAS): age, pre-operative left ventricular outflow tract (LVOT) gradient, distance from obstructive subaortic ridge to aortic valve (AoV), and peeling of membrane from the aortic/mitral valves. We sought to develop a prediction rule to categorize risk of reintervention for recurrent SubAS and guide follow-up in patients with discrete SubAS. Methods We retrospectively reviewed patients who underwent SubAS resection between 1984 and 2016. Our primary outcome was reintervention for recurrent SubAS post-discharge. Kaplan–Meier estimates were used for time-to-event analysis of any reintervention . Multivariable models were used to create a prediction rule. We excluded patients without 3 years of follow-up. Results Of 172 patients, 21 (12.2%) required reintervention. The following characteristics predicted reintervention: age > 65 mmHg (p = 0.011), peeling of membrane from the mitral valve (p -2.5 (p Conclusions A prediction rule that incorporates patient’s age at index surgery, membrane to aortic valve distance, and associated left heart lesions can determine the likelihood of reintervention for recurrent SubAS.