title: The long-term outcome of open valvotomy for critical aortic stenosis in neonates.
abstract: BACKGROUND
  This study analyzed the long-term outcome after operations for open aortic valvotomy, specifically looking at the preservation of the native aortic valve.
  
  
  METHODS
  Between 1983 and 2011, 34 neonates with critical aortic stenosis underwent open valvotomy. The mean age at operation was 15 days (range, 1 to 28 days). Follow-up was 100% complete.
  
  
  RESULTS
  Three patients died early. The probability of survival was 91.2%, with a mean follow-up of 11 years (range, 10 months to 21 years). Event-free survival was 77%, 68%, 68%, and 57% at 5, 10, 15, and 20 years, respectively, and freedom from aortic valve replacement was 93%, 83%, 68%, and 57%. Tricuspid valve morphology revealed the best outcome, with event-free survival of 90% (p = 0.006) and 100% freedom from aortic valve replacement (p = 0.0012) at 20 years of follow-up. All but 4 patients were in New York Heart Association class I; 77 % of all patients were without medication.
  
  
  CONCLUSIONS
  In neonates, predictable and consistent long-term results can be accomplished by open valvotomy in any type of valve morphology, even in an asymmetric arrangement. Operative repair not only offers a 90% survival benefit in the long-term but also preserves the native aortic valve in most patients. Clearly superior results were achieved in tricuspid valve morphology, in which there was no need for aortic valve replacement at 20 years of follow-up.
authors.affiliation: German Pediatric Cardiac Center, Sankt Augustin, Germany. v.hraska@asklepios.com
authors.forename: Viktor
authors.initials: V
authors.lastname: Hraška
authors.forename: Nicodeme
authors.initials: N
authors.lastname: Sinzobahamvya
authors.forename: Christopher
authors.initials: C
authors.lastname: Haun
authors.forename: Joachim
authors.initials: J
authors.lastname: Photiadis
authors.forename: Claudia
authors.initials: C
authors.lastname: Arenz
authors.forename: Martin
authors.initials: M
authors.lastname: Schneider
authors.forename: Boulos
authors.initials: B
authors.lastname: Asfour
mesh_terms: D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D016638:Critical Illness; D006801:Humans; D007231:Infant, Newborn; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome