Establishment of prognostic prediction model for patients with supravalvular aortic stenosis

Lang Xinyue; Lyu Lizhi; Wang Cheng; Wang Qiang; Liu Zhiguang

doi:10.3760/j.issn.1673-4777.2025.05.002

Abstract：Objective The aim of this study is to establish a model to predict the risk of restenosis or reintervention in patients with supravalvular aortic stenosis(SVAS)after surgical repair based on the data of two Chinese heart centers.Methods This study enrolled 291 patients diagnosed with SVAS and underwent surgical repair from two cardiac centers,Fuwai Hospital,Chinese Academy of Medical Sciences and Yunnan Fuwai Cardio-vascular Hospital,from May 2002 to January 2020.The primary end point was restenosis or reintervention(reoperation or intervention)during postoperative follow-up.Cox regression was used to explore the risk factors affecting the primary endpoint and to construct a prediction model.The receiver operating characteristic curve was used to determine the predictive efficacy of the prediction model.Results Among 291 SVAS patients,98 were female(33.7％),and the mediansurgical age was 4.9(2.3,9.9)years old.The medianfollow-up time was 24.0(6.0,54.0)months.Echocardiographic follow-up was completed in 240 patients(82.5％),including 157 males and 83 females.During the follow-up period,no death occurred,restenosis occurred in 33 patients(13.8％),and 8 patients(3.3％)underwent reintervention(including reoperation or interventional therapy).Multivariate Cox regression analysis showed that type Ⅱ SVAS,combined with pulmonary artery stenosis,combined with aortic valve stenosis,sinotubular junction Z score and sinotubular junction pressure gradient were independent risk factors for long-term restenosis or reintervention and were included in the prediction model(all P＜0.05).The area under the curve of the prediction model was 0.846(95％confidence interval:0.763-0.928).Conclusions This study identified key variables that predict the occurrence of restenosis or reintervention after surgical treatment of SVAS.A predictive model is established that can predict the risk of restenosis or reintervention in patients after SVAS surgery,which can be used as a practical method for individualized risk assessment of SVAS patients after surgery.