Abstract
In this study we evaluated 77 patients (pt) operated upon over 1 year (y) of age who had isolated aortic valve stenosis (AS) and whose follow-up (FU) is at least 2y. There was no operative (op) death. Mean age at valvotomy was 10y (1-17y) and mean FU period was 9y (2-28y). In 50 pt who had postop (po) catheterization (cath), peak systolic pressure gradient between LV and AO (PSPG) decreased in all. In 5/50 PSPG was above 50 mgHg at initial po cath (persistent AS). Out of 15 pt who had two po cath,increased PSPG was demonstrated after apparently adequate initial relief of obstruction in 7 (recurrent AS). 20 pt (26%) required reoperation (reop) during this period at mean age of 18y (10-33y); 5 for persistent AS, 7 for recurrent AS and 8 for severe aortic insufficiency (AI). There was one op death and 2 late deaths. Most of pt who survived reop were in NYHA class I at FU.
Of the 57 non-reop pt, 56 were asymptomatic. AI was present in 44 and was severe in 9 who may require valve replacement in future. In all of 32 non-reop pt who had po cath, PSPG was less than 50 mmHg. The reop group (Gp) had higher preop PSPG (75 vs 92mmHg), higher incidence of severe AI and had more symptoms of congestive heart failure after initial valvotomy than non-reop Gp. We conclude that majority of children improve following aortic valvotomy. However, by young adulthood,26% of pt require reop for recurrent or persistent AS and/or severe AI. Valvotomy in childhood did not prevent eventual valve replacement in these pt.
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Park, I., Vargo, T., Cooley, D. et al. 182 LONG-TERM RESULT OF AORTIC VALVOTOMY FOR ISOLATED CONGENITAL AORTIC VALVE STENOSIS IN CHILDREN. Pediatr Res 15 (Suppl 4), 470 (1981). https://doi.org/10.1203/00006450-198104001-00191
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DOI: https://doi.org/10.1203/00006450-198104001-00191