Repeat aortic valvotomy in children.
The outcome in 13 children with congenital valvar aortic stenosis who underwent a repeat valvotomy for significant residual obstruction was reviewed. There was no hospital mortality (confidence limits 0% to 32%), while one late death (8%) occurred (confidence limits 1% to 57%) following the repeat procedure. Cardiac catheterization was performed in 10 patients (77%) following the second valvotomy (2 years, 7 months mean follow-up): (1) three children, all infants at initial valvotomy, had a peak systolic ejection gradient less than or equal to 40 mm Hg and only mild, at most, aortic regurgitation after the repeat operation; (2) the other seven had a peak systolic ejection gradient greater than 40 mm Hg or at least moderate aortic regurgitation, of whom two were infants at first valvotomy while the others ranged in age from 1 to 12 years at initial surgery. These results suggest that repeat aortic valvotomy may not significantly improve the hemodynamic status of those who did not require initial valvotomy early in life.
D000293:Adolescent; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000151:congenital / Q000601:surgery*; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010043:Outcome and Process Assessment, Health Care; D012086:Reoperation; D013318:Stroke Volume