Evidence map›Paper›PMID 40032608›Full record

ArticleOpen heart2025

Reinterventions in patients with congenital aortic stenosis and a commissurotomy.

Mostafa Mahmoud, Bengt Johansson, Daniel Rinnstrom, Camilla Sandberg, Christina Christersson, Peder Sörensson, Alexandra Trzebiatowska-Krzynska, Zacharias Mandalenakis, Joanna Hlebowicz, Johan Ljungberg

Abstract read
In one paragraph

Article in Open heart, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mostafa MahmoudPublic Health and Clinical Medicine, Umeå Universitet, Umea, Sweden.
Bengt JohanssonDepartment of Diagnostics and Intervention, Umeå Universitet, Umea, Västerbotten, Sweden bengt.johansson@umu.se.ORCID http://orcid.org/0000-0003-0976-6910
Daniel RinnstromDepartment of Diagnostics and Intervention, Umeå Universitet, Umea, Västerbotten, Sweden.
Camilla SandbergDepartment of Community Medicine and Rehabilitation, Umeå Universitet, Umea, Västerbotten, Sweden.ORCID http://orcid.org/0000-0002-4043-7130
Christina ChristerssonDepartment of Medical Sciences, Cardiology, Uppsala Universitet, Uppsala, Uppsala, Sweden.
Peder SörenssonDepartment of Medicine, Solna, Karolinska Institutet, Stockholm, Stockholm, Sweden.
Alexandra Trzebiatowska-KrzynskaDepartment of Cardiology, Medicine and Health Sciences, Linköping University, Linkoping, Sweden.
Zacharias MandalenakisDepartment of Institute of Medicine, Goteborgs universitet Sahlgrenska Akademin, Goteborg, Sweden.
Joanna HlebowiczDepartment of Cardiology, Lunds Universitet, Lund, Sweden.
Johan LjungbergPublic Health and Clinical Medicine, Umeå Universitet, Umea, Sweden.ORCID http://orcid.org/0000-0002-3002-4877

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn congenital aortic stenosis (CAS), commissurotomy is an option in patients not suitable to receive a valve prosthesis. However, there is often a need for future additional interventions on the aortic valve. The fate of the aortic valve is, however, essentially unknown. This study reports the need for reinterventions after surgical commissurotomy, based on a national register. MATERIALS AND

methodsThe national register on congenital heart diseases (CHDs) was searched for patients with CAS, simple or associated with other CHD and an index commissurotomy with later data from follow-up.

results300 patients with CAS and an index commissurotomy (mean age at the operation 7.4±7.8 years, 72.4% males) were identified. After an observation time of 27.4±10.0 years, 54.7% of the patients had a reintervention that occurred 14.2±10.1 years after the index operation. The cumulative incidence of reintervention was approximately 25% 10 years after and 60% 30 years after the index intervention. The prevalence of left ventricular hypertrophy (LVH) was higher among those that needed reintervention (41.3 vs 26.8%, p=0.023). Furthermore, eight patients died with a cumulative incidence of 7% 30 years after the index intervention, where most were (7/8) without reintervention (p=0.025). There were no additional important differences between patients with and without reintervention. The prevalence of left ventricular dysfunction and New York Heart Association class >1 was low.

conclusionMost (54.7%) patients with a commissurotomy, more than half of them within 30 years and eventually all will need a reintervention. This is important information to patients, especially for women in childbearing age. The higher prevalence of LVH in the group with reintervention needs attention during follow-up. Furthermore, those without reintervention, for unknown reasons, had a higher mortality. Our data strengthen the arguments for close outpatient follow-up among patients with a previous commissurotomy.

Indexed as

Aortic ValveAortic Valve StenosisCardiac Surgical ProceduresAdolescentAdultChildChild, PreschoolFemaleFollow-Up StudiesHumansIncidenceInfantMaleRegistriesReoperationRetrospective StudiesAortic Valve StenosisCongenital AbnormalitiesEpidemiologyHeart Defects, CongenitalHeart Valve Prosthesis Implantation

Identifiers

PMID40032608
PMCPMC11877264

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.