ArticleWorld journal of pediatrics : WJP2026
Discrete subaortic stenosis: prognostic value of the left ventricular outflow tract gradient and implications for earlier surgical intervention.
Article in World journal of pediatrics : WJP, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundThe optimal timing of surgery for discrete subaortic stenosis (DSS) is controversial due to limited evidence from large-scale trials. This study aimed to identify prognostic factors and reassess current surgical thresholds.
methodsA total of 508 patients with DSS, including 375 pediatric patients, who underwent surgery at a single tertiary center between May 2018 and March 2025 were retrospectively analyzed. The primary endpoint was a composite of DSS-related adverse events, and the secondary endpoint was aortic valve (AV) dysfunction. Multivariable Cox regression and receiver operating characteristic (ROC) analyses were used to identify predictors.
resultsOver a mean follow-up period of 3.5 years, 19.2% of pediatric patients experienced the primary endpoint and 13.3% developed AV dysfunction. Left ventricular outflow tract gradients (LVOTG) ≥ 20 mmHg [hazards ratio (HR) = 4.0, 95% confidence interval (CI): 2.0-7.8, P < 0.001], ≥ 35 mmHg (HR = 6.1, 95% CI: 3.2-11.6, P < 0.001), and ≥ 50 mmHg (HR = 3.5, 95% CI: 1.9-6.4, P < 0.001) were all independently associated with adverse outcomes. Of note, an LVOTG ≥ 35 mmHg provided comparable prognostic accuracy to ≥ 50 mmHg (P = 0.180) but superior risk discrimination compared with 20 mmHg ≤ LVOTG < 35 mmHg (P < 0.001). Additional independent predictors included older age at surgery, moderate or greater aortic regurgitation.
conclusionsAn LVOTG threshold of ≥ 35 mmHg may offer a more appropriate risk-alert threshold than the current ≥ 50 mmHg standard. Earlier surgical intervention, particularly in patients with AV involvement, may help improve long-term outcomes in DSS.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.