Congenital Aortic Stenosis : Long-Term Surgical Results and Unsolved Problems

2015 ◽  
pp. 216-224
Author(s):  
Bruce C. Paton ◽  
James R. Stewart
Keyword(s):  
Aortic Stenosis ◽  
Surgical Results ◽  
Congenital Aortic Stenosis

Long-term follow-up of valvotomy before 1968 for congenital aortic stenosis

1986 ◽  
Vol 58 (3) ◽  
pp. 338-341 ◽  
Author(s):  
Kai-Sheng Hsieh ◽  
John F. Keane ◽  
Alexander S. Nadas ◽  
William F. Bernhard ◽  
Aldo R. Castaneda
Keyword(s):  
Aortic Stenosis ◽  
Congenital Aortic Stenosis ◽  
Long Term Follow Up

Surgical Valvuloplasty Versus Balloon Dilation for Congenital Aortic Stenosis in Pediatric Patients

2020 ◽  
Vol 11 (4) ◽  
pp. 444-451 ◽  
Author(s):  
Jeremy L. Herrmann ◽  
Aaron J. Clark ◽  
Cameron Colgate ◽  
Mark D. Rodefeld ◽  
Mark H. Hoyer ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Balloon Dilation ◽  
Aortic Insufficiency ◽  
Term Survival ◽  
Old Patients ◽  
Congenital Aortic Stenosis ◽  
Kaplan Meier ◽  
Aortic Valvuloplasty

Background: For children with congenital aortic stenosis (AS) who are candidates for biventricular repair, valvuloplasty can be achieved by surgical aortic valvuloplasty (SAV) or by transcatheter balloon aortic dilation (BAD). We aimed to evaluate the longer term outcomes of SAV versus BAD at our institution. Methods: We retrospectively reviewed the outcomes of 2 months to 18 years old patients who underwent SAV or BAD at our institution between January 1990 and July 2018. Baseline and follow-up characteristics were assessed by echocardiography. Long-term survival, freedom from reintervention, freedom from aortic valve replacement (AVR), and aortic regurgitation were evaluated. Results: A total of 212 patients met inclusion criteria (SAV = 123; BAD = 89). Age, sex, aortic insufficiency (AI), and aortic valve gradient were similar between the groups. At 10 years, 27.9% (19/68) of SAV patients and 58.3% (28/48) of BAD patients had moderate or worse AI ( P = .001), and reintervention occurred in 39.2% (29/74) of SAV patients and 78.6% (44/56) of BAD patients ( P < .001). Kaplan-Meier analysis revealed overall survival was 96.8% (119/123) for SAV and 95.5% (85/89) for SAV ( P = .87). At 10 years, 35% (23/66) of SAV patients and 54% (23/43) of BAD patients underwent AVR ( P = .213). Conclusions: Surgical aortic valvuloplasty demonstrated greater gradient reduction, less postoperative and long-term AI, and a lower reintervention rate at 10 years than BAD. There was no difference in survival or AVR reintervention rate. Surgical aortic valvuloplasty is a durable and efficacious intervention and should continue to be considered a favorable choice for palliation of valvular AS.

scholarly journals Long-term Evaluation of Aortic Valvotomy for Congenital Aortic Stenosis

1987 ◽  
Vol 206 (4) ◽  
pp. 496-503 ◽  
Author(s):  
KEVIN J. TVETER ◽  
JOHN E. FOKER ◽  
JAMES H. MOLLER ◽  
W. STEVES RING ◽  
C. WALTON LILLEHEI ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Congenital Aortic Stenosis ◽  
Term Evaluation

Subvalvular Aortic Stenosis: Long-term Surgical Results

1983 ◽  
Vol 31 (02) ◽  
pp. 96-100 ◽  
Author(s):  
J. Binet ◽  
J. Losay ◽  
S. Demontoux ◽  
C. Planche ◽  
J. Langlois
Keyword(s):  
Aortic Stenosis ◽  
Surgical Results ◽  
Subvalvular Aortic Stenosis

scholarly journals Long-term outcome of congenital aortic valve stenosis: predictors of reintervention

2014 ◽  
Vol 25 (5) ◽  
pp. 893-902 ◽  
Author(s):  
Léa Hochstrasser ◽  
Patrick Ruchat ◽  
Nicole Sekarski ◽  
Michel Hurni ◽  
Ludwig K. von Segesser
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Post Intervention ◽  
Term Outcome ◽  
Congenital Aortic Stenosis ◽  
Long Term Outcome ◽  
Posterior Wall Thickness

AbstractObjectives:To evaluate long-term outcome of initial aortic valve intervention in a paediatric population with congenital aortic stenosis, and to determine risk factors associated with reintervention.Patients and methods:From 1985 to 2009, 77 patients with congenital aortic stenosis and a mean age of 5.8±5.6 years at diagnosis were followed up in our institution for 14.8±9.1 years.Results:First intervention was successful with 86% of patients having a residual peak aortic gradient <50 mmHg, and the proportion of patients with grade >1 regurgitation increased by 7%. Long-term survival after the first procedure was excellent, with 91% survival at 25 years. At a mean interval of 7.6±5.3 years, 30 patients required a reintervention (39%), mainly because of a recurrent aortic stenosis. Freedom from reintervention was 97, 89, 75, 53, and 42% at 1, 10, 15, 20, and 25 years, respectively. Predictors of reintervention were residual peak aortic gradient (p=0.0001), aortic regurgitation post-intervention >1 (p=0.02), prior balloon aortic valvuloplasty (p=0.04), and increased left ventricular posterior wall thickness (p=0.1).Conclusions:Aortic valve intervention is a safe and effective procedure for congenital aortic stenosis with excellent survival results. However, rate of reintervention is high and influenced by increased left ventricular posterior wall thickness pre-intervention, prior balloon valvuloplasty, higher residual peak systolic valve gradient, and more than mild regurgitation post-intervention. The study highlights that long-term follow-up is recommended for these patients.

Long-term survival and freedom from reintervention in patients with congenital aortic stenosis

2007 ◽  
Vol 55 (S 1) ◽  
Author(s):  
B Nasseri ◽  
M Zimmer ◽  
P Ewert ◽  
H Abdul-Khaliq ◽  
M Hübler ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Term Survival ◽  
Congenital Aortic Stenosis ◽  
Long Term Survival
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