Back to Search
Start Over
Long-term outcomes of primary aortic valve repair for isolated congenital aortic stenosis in children.
- Source :
-
The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2022 Nov; Vol. 164 (5), pp. 1263-1274.e1. Date of Electronic Publication: 2022 Mar 16. - Publication Year :
- 2022
-
Abstract
- Objective: We aimed to assess the long-term outcomes of children with isolated congenital aortic stenosis who underwent primary aortic valve repair.<br />Methods: Records of all children (n = 111) with isolated congenital aortic stenosis who underwent primary aortic valve repair between 1980 and 2016 were reviewed. An optimal operative outcome consisted of a residual left ventricular outflow tract peak systolic gradient <35 mm Hg and trivial or less aortic insufficiency.<br />Results: Median age at surgery was 0.4 years (interquartile range, 1 month-7.9 years) and median weight at surgery was 7.0 kg (interquartile range, 3.7-25.0 kg). Fifty-two patients (46.8%; 52/111) underwent aortic valve repair with the use of patch material. Early mortality was 0.9% (1/111). Late mortality was 0.9% (1/110). Freedom from aortic valve reoperation was 52.1% (95% CI, 38.7-63.8) at 10 years. Freedom from aortic valve replacement was 67.9% (95% CI, 55.4-77.5) at 10 years. An optimal outcome was achieved in 48 patients (43.2%; 48/111). At 10 years, freedom from aortic valve reoperation was 78.2% (95% CI, 63.1-87.8) in patients with an optimal outcome, compared with 39.4% (95% CI, 22.8-55.6) in those with a suboptimal outcome (P = .03). Tricuspid aortic valve was associated with a suboptimal outcome (P = .01).<br />Conclusions: Aortic valve repair achieves relief of congenital aortic stenosis with very low early mortality and excellent long-term survival, even in neonates. Although nearly half of the patients required aortic valve reoperation by 10 years, two-thirds of the patients remain free from aortic valve replacement. An optimal outcome was more commonly achieved with bicuspid aortic valves compared with tricuspid aortic valves.<br /> (Crown Copyright © 2022. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aortic Valve abnormalities
Aortic Valve diagnostic imaging
Aortic Valve surgery
Child
Follow-Up Studies
Humans
Infant, Newborn
Reoperation
Retrospective Studies
Treatment Outcome
Aortic Valve Insufficiency surgery
Aortic Valve Stenosis congenital
Aortic Valve Stenosis diagnostic imaging
Aortic Valve Stenosis surgery
Cardiac Surgical Procedures
Heart Defects, Congenital surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1097-685X
- Volume :
- 164
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The Journal of thoracic and cardiovascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 35430079
- Full Text :
- https://doi.org/10.1016/j.jtcvs.2021.11.097