[Valvotomy and congenital aortic valve stenosis. Long-term results].
Twenty nine patients (average age 11 years) underwent valvotomy for congenital valvular aortic stenosis from 1967 to 1983. The medium and long-term results were analysed retrospectively: 14 children have been reoperated; 11 for restenosis and 3 for aortic regurgitation after an average period of 11 years. Thirteen of the other 15 patients have been regularly followed-up for about 10 years: there are 7 good results, 3 average results and 3 restenoses. One patient was lost to follow-up after 9 years and the other patient died secondarily of a non-cardiac cause. This series was compared to a previous one of 35 cases of valvular aortic stenosis who underwent valvotomy between 1954 and 1964. There were 6 deaths in the perioperative period and 6 during follow-up (on average 11 years after surgery), including 3 sudden deaths. Eleven patients were reoperated: 2 for endocarditis, 5 for restenosis and 4 for aortic regurgitation (on average after 13 years). Three patients were lost to follow-up and there are 9 survivors who have not been reoperated (average follow-up 27 years): 5 of these patients were reexamined; there were 2 excellent results, 2 average results and 1 restenosis. These results show that conservative surgery of congenital valvular aortic stenosis is now a low risk procedure in children, but it is a palliative solution. The main problem is that of follow-up to detect restenosis because of the risk of sudden death. This follow-up is much easier since the introduction of Doppler echocardiography, eventually associated with exercise stress testing in doubtful cases.(ABSTRACT TRUNCATED AT 250 WORDS)
Perchet
H
H
Service de cardiologie, Hôpital Henri-Mondor, Créteil.
Gaudeau
S
S
Casasoprana
A
A
Corone
P
P
Castaigne
A
A
Vernant
P
P
D000293:Adolescent; D000328:Adult; D001024:Aortic Valve Stenosis / Q000151:congenital* / Q000628:therapy; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D007223:Infant; D012189:Retrospective Studies
Valvulotomie et sténose aortique orificielle congénitale. Résultats à long terme.