{
  "abstract": "Objective\n\nSupravalvular aortic stenosis (SVAS) repair carries a moderate risk for postoperative aortic regurgitation (AR). This may be related to the targeted sinotubular junction diameter z score (STJDZ) at reconstruction, traditionally sized to zero. We investigated relationships between achieved STJDZ and aortic valve function after repair.Methods\n\nSixty-six children underwent patch repair from 2010 to 2024 at a median age of 1.2 years (interquartile range [IQR], 0.4, 3.5 years) via Brom (n = 53), Doty (n = 9), and McGoon (n = 4) techniques. Relationships between STJDZ and aortic valve function were assessed via Jonckheere-Terpstra nonparametric test for trend over median follow-up of 5.6 years (IQR, 2.4, 8.4 years).Results\n\nPreoperatively, AR was none/trivial in 52 (79%), left ventricular outflow tract obstruction (LVOTO) moderate or greater in 54 (82%), and median STJDZ -3.8 (IQR, -4.4, -2.9). At discharge, AR and LVOTO were mild or greater in 45 (68%) and 18 (27%), and median STJDZ was -0.3 (IQR, -1.3, -1.1). STJDZ increased by a median of 3.0 (IQR, 1.6, 4.4) preoperatively to postoperatively. Discharge AR was none/trivial at median STJDZ -1.3 (IQR, -1.8, -0.1) and worsened with increasing diameters (mild: 0.4 [IQR, -1.0, 1.8], mild+: 0.0 [IQR, -1.2, 1.5]; P = .038), with similar results at follow-up (P = .048). LVOTO worsened with lower median STJDZ (none/trivial: 0.2 [IQR, -1.2, 1.5], mild: -1.3 [IQR, -3.2, -0.1]; P = .015). Subanalysis of those with none/trivial preoperative AR (n = 52) showed that increase in STJDZ by ≥4 demonstrated worse follow-up AR (P = .016).Conclusions\n\nAchieving STJDZ zero using patch repair techniques to relieve SVAS obstruction demonstrated mild or greater postoperative AR compared with none/trivial regurgitation at median z score -1.3. Mild LVOTO was noted with median z score -1.3. Targeting STJDZ of -1 in pediatric SVAS repair appears appropriate to balance residual regurgitation and LVOTO. Further follow-up is required to understand the long-term impact of this target on aortic growth.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiac Surgery, Boston Children's Hospital, Boston, Mass.",
    "Department of Surgery, Harvard Medical School, Boston, Mass.",
    "Department of Cardiology, Boston Children's Hospital, Boston, Mass.",
    "Department of Pediatrics, Harvard Medical School, Boston, Mass."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Dominic P Recco"
    },
    {
      "affs": [
        0
      ],
      "name": "Lauren Marshall"
    },
    {
      "affs": [
        2
      ],
      "name": "Matthew Schildmeier"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Kimberlee Gauvreau"
    },
    {
      "affs": [
        0
      ],
      "name": "Joseph Confessore"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Luis G Quinonez"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Pedro J Del Nido"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Christopher W Baird"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Peter E Hammer"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "David M Hoganson"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e3v8b365c7r94.bib",
  "cited_by": 0,
  "doi": "10.1016/j.xjon.2026.101941",
  "fulltext_url": "https://europepmc.org/articles/PMC13711173",
  "id": "e3v8b365c7r94",
  "issns": [
    "2666-2736"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948104",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Congenital: Aorta"
    ],
    [
      "openalex",
      "2713|Congenital Heart Disease Studies"
    ]
  ],
  "openalex": "W7165764623",
  "pdf_url": "https://europepmc.org/articles/PMC13711173?pdf=render",
  "pmcid": "PMC13711173",
  "pmid": "42948104",
  "published": "2026-06-24",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/e3v8b365c7r94.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:36Z",
      "native_id": "MED:42948104",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948104"
    },
    {
      "first_seen": "2026-10-31T12:22:00Z",
      "native_id": "PMC13711173",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.xjon.2026.101941"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Congenital Heart Disease Studies",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Postoperative root size predicts regurgitation in supravalvular aortic stenosis repair.",
  "title_text": "Postoperative root size predicts regurgitation in supravalvular aortic stenosis repair.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:00Z",
  "url": "https://research.draconitic.com/paper/e3v8b365c7r94",
  "venue": "JTCVS open",
  "versions": []
}