Left Ventricular Outflow Tract Obstruction in Aortic Arch Anomalies With Ventricular Septal Defect

The presence of a bicuspid aortic valve and an aortic valve annular z-score of −3.0 or less before primary repair are risk factors for LVOTO, and stenotic bicuspid valves and discrete subvalvular LVOTO are the main causes of LVOTO after primary repair of CoA/IAA with ventricular septal defect. The bicuspid patients more frequently required reoperation than the tricuspid patients.