The aim of the study is to evaluate the medical and healthcare problems of the ACHD with operated on isolated discrete subaortic stenosis (IDSS)in childhood.

Thirty seven patients were selected, mean age 25.6 ± 5.4 years, followed up for 13.3 ± 5.1 years after surgery. The postoperative result was assessed as unsatisfactory in cases with peak gradient (PG) over 50 mm Hg and moderate-severe aortic regurgitation (AR). Social functioning was compared to the official statistical data. Healthcare was assessed on the basis of frequency of the medical check-up.

PG increased from 15 ± 13 mm Hg immediately after the operation to 33 ± 27 mm Hg at last control (p=0.0001). Twelve pts (35.5 %) had unsatisfactory postoperative result due to restenosis (90%), AR (25%). ReOp was performed in 7 (18.9%). The probability for satisfactory postoperative result decreased from 86% to 79%, 73% and 52% at the age of 18, 25, 30 and 35 years. When compared to the official data, there is higher unemployment rate ((p = 0.005) despite the higher educational level (p=0.015). The period with no specialized medical check-up for the study group is 5.8 ± 4.5 years, significantly longer when compared to patients below 18 years (p = 0.0001).
There are significant medical problems in at least 1/3 of the ACHD patients operated on for IDSS in childhood that have to be assessed and treated in a specialized medical center. The quality of life of the patients is good in the setting of deteriorated social functioning.