A new operation for aortic stenosis in the young: total left ventricular output through an apical-abdominal aortic shunt. A seven year follow-up.
Left ventricular outflow disease causes particular problems in the small child. Although aortic stenosis may be palliated by commissurotomy, valve replacement, if that appears necessary, is essentially not a practical procedure due to the small valve necessary to occupy the sub-coronary position. The combined lesion of aortic stenosis and regurgitation in childhood is an especially difficult lesion because any attempt to relieve the stenosis is extremely likely to increase the regurgitation. Sometime ago, we had the opportunity to manage a 22-month old youngster with severe congestive failure due to aortic stenosis with regurgitation. Because of the small size of the aortic root, it was elected to close the aortic valve and perform an apical abdominal aortic valve-containing shunt such that the entire left ventricular outflow was delivered to the abdominal aorta. The child has now been followed over seven years and is the subject of this report.
D001012:Aorta, Abdominal / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery*; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D006328:Cardiac Catheterization; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology; D006350:Heart Valve Prosthesis; D006801:Humans; D007231:Infant, Newborn; D008297:Male