• Yi-Chia Wang, Heng-Wen Chou, Chi-Hsiang Huang, Ming-Tai Lin, Chun-An Chen, Shuenn-Nan Chiu, Chun-Wei Lu, Yih-Sharng Chen, and Shu-Chien Huang.
• Department of Anesthesiology, National Taiwan University Hospital, Taiwan.
• J Formos Med Assoc. 2024 Sep 10.

BackgroundLeft ventricular outflow tract obstruction (LVOTO) re-intervention is a significant cause of morbidity and mortality in patients with coarctation of the aorta (CoA) or interrupted aortic arch (IAA) after aortoplasty.MethodsThis retrospective study analyzed data from neonates with IAA/CoA who underwent biventricular repair between 2012 and 2022. LVOTO events were defined by the detection of color Doppler flow acceleration ≥3.0 m/s at the valvular, subvalvular, or supravalvular regions via transthoracic echocardiography, and the necessity for surgical or catheter intervention to relieve the obstruction.ResultsAmong 121 neonates with CoA/IAA, 16 (13.7%) primary aortoplasty patients developed LVOTO. Additionally, one patient (25%) who underwent a staged Yasui operation developed LVOTO due to a narrowed ventricular septal defect-pulmonary atresia tunnel. During follow-up, 58% of patients with a bicuspid valve and 25% of patients with a subaortic ridge developed LVOTO. The combination of either a bicuspid valve, subaortic ridge, or an aortic valve annulus Z-score < -3.0 predicted a high re-intervention rate (7/8 [87.5%]).ConclusionsIn patients with IAA/CoA, the presence of multiple risk factors, including a bicuspid valve, subaortic ridge, and an aortic valve annulus Z-score < -3.0, is associated with a significantly increased rate of re-intervention for LVOTO.Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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