Valvotomy for isolated congenital aortic stenosis in children: prognostic factors for outcome.
Early and late results after surgery for isolated congenital valvar aortic stenosis were evaluated in a total of 86 children under 16 years of age (mean 7.4 years). Primary procedure was always conservative. There were 7/86 (8.1%) early deaths. All infants who died after the operation were younger than 4 months of age. Among the clinical variables tested by the univariate analysis only age and duration of cardiopulmonary bypass were significant prognostic factors for early death. There were 6/67 (7.7%) valve-related late deaths. Multivariate analysis could not identify any risk factors for early and late mortality. Actuarial survival was 97% (95% CL 93-101%) after 5 years, 94% (88-100%) after 10 years, 90% (82-98%) after 15 years, and 87% (77-97%) after 20 years. A total of 22/79 (28%) early survivors had a first reoperation and 5 had a second reoperation. Long follow-up interval was the only significant factor for reoperation. Actuarial reoperation-free interval was 91% (85-98%) after 5 years, 70% (58-81%) after 10 years, and 50% (34-64%) after 15 years. Significant factors for poor valve function were long duration of follow-up, endocarditis, and young age at operation. The probability of normal valve function was 91% (84-98%) after 5 years, 67% (55-79%) after 10 years, and 54% (40-68%) after 15 years.
Bauer
E P
EP
Clinic for Cardiovascular Surgery, University Hospital, Zurich, Switzerland.
Schmidli
J
J
Vogt
P R
PR
von Segesser
L K
LK
Turina
M I
MI
D000206:Actuarial Analysis; D000704:Analysis of Variance; D001024:Aortic Valve Stenosis / Q000151:congenital* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011183:Postoperative Complications / Q000401:mortality*; D011379:Prognosis; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome