title: Outcome of a repair-oriented strategy for the aortic valve in children.
abstract: BACKGROUND
  We sought to evaluate the mid-term results of a repair-oriented strategy of the aortic valve in children.
  
  
  METHODS
  Between February 2007 and November 2011, we performed 39 aortic valve repairs in children. Median age and weight at surgery were 5.5 years (3 days-18 years) and 16.7 kg (2.7-83.5), respectively. A total of 11 (28%) patients had one or more prior surgical or interventional cardiologic procedures. Median intensive care unit and hospital stay were two (1-96) and five (3-96) days, respectively. Median and cumulative follow-up were 12.7 months (15 days-64 months) and 48.9 patient-years, respectively.
  
  
  RESULTS
  There were 3 (7.7%) early deaths all in patients undergoing additional complex cardiac procedures. Two (5.1%) patients required early surgical revision. Twenty-six (66%) patients had isolated or mixed aortic stenosis. The median gradient reduced from 62.4 (range 16-144) to 17.6 mm Hg (range 0-51.8), postoperatively (P = .02). At last follow-up, the median gradient remained largely unchanged at 21.1 mm Hg (0-49; P = .02). Twenty-six (66%) patients had isolated or mixed aortic valve regurgitation (mild in 8 [20%], moderate in 15 [38%], and severe in 6 ([15%] patients). The degree of aortic regurgitation improved in all patients with moderate or severe aortic regurgitation (P = .04). At last follow-up, two patients had moderate aortic regurgitation. Kaplan Meier freedom from reintervention in the survivors was 95% at three years.
  
  
  CONCLUSIONS
  A repair-oriented strategy for the aortic valve in children has satisfactory early and mid-term results and remains a promising management option in children with aortic valve disease.
authors.affiliation: Cardiac Surgical Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom.
authors.forename: Pramod
authors.initials: P
authors.lastname: Kandakure
authors.forename: Natasha
authors.initials: N
authors.lastname: Prior
authors.forename: Giri
authors.initials: G
authors.lastname: Soda
authors.forename: Joyce
authors.initials: J
authors.lastname: Lim
authors.forename: Ram
authors.initials: R
authors.lastname: Dhannapuneni
authors.forename: Prem
authors.initials: P
authors.lastname: Venugopal
authors.forename: Nelson
authors.initials: N
authors.lastname: Alphonso
mesh_terms: D001022:Aortic Valve Insufficiency / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies
keywords: CHD; aortic valve; heart valve; pediatric; repair; valve lesions