[Aortic valve stenosis in children. Surgical valvuloplasty long-term results].
From 1960 through 1992, 67 children with congenital aortic stenosis aged 6-228 months (M 105.7 +/- 52) were submitted to aortic valvuloplasty at our institution. There was no hospital mortality. During the follow-up of 127.5 +/- 66.7 months, there were two late valve related deaths. Eight patients (11.9%) developed aortic regurgitation 5 to 125 months (M 66.6 +/- 35) following surgical valvuloplasty and one of them required aortic valve replacement. Because of restenosis, 15 patients required a second operation. Of them five children underwent a second aortic valvuloplasty without mortality and, in four of them, the functional result has been excellent after a mean follow-up of 75.4 +/- 12 months. Ten patients required an aortic valve replacement 62 to 208 months post-op (M 100.9 +/- 50.8). Mechanical prosthesis were used in 6 and bioprosthesis in 4. Two patients required a Konno and one patient a Ross procedure. There were no early nor late deaths following reoperations. The 20 year survival rate following the first valvuloplasty was 94%, the freedom from reoperation 63% and the freedom from aortic valve replacement 73% for the same time period. Our results demonstrate that congenital aortic valvar stenosis in children can be surgically well controlled until adulthood. Our study also illustrates that surgical valvuloplasty is a safe and efficacious procedure and that its beneficial effect is maintained over 20 years in the majority of children.
Chartrand
C
C
Service de Chirurgie Cardio-Vasculaire, Hôpital Sainte-Justine, Montréal, Québec, Canada.
Saro-Servando
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E
Vobecky
J S
JS
D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003646:Debridement / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D004106:Dilatation / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome
Sténose valvulaire aortique chez l'enfant. Résultats à long terme de la valvuloplastie chirurgicale.