[Progress of surgical treatment for aortic valve diseases in children]

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Biomaterials in Medicine

Background:

• Aortic valve stenosis (AVS) in children necessitates effective treatment options.
• Surgical aortic valvotomy (SAV) and balloon aortic valvuloplasty (BAV) are established treatments, with SAV offering superior long-term outcomes.
• Controversy persists regarding the optimal initial treatment for pediatric AVS.

Purpose of the Study:

• To review current and emerging treatment modalities for pediatric aortic valve stenosis.
• To compare the efficacy and long-term results of various surgical and interventional approaches.
• To highlight advancements in aortic valve repair and replacement techniques.

Main Methods:

• Review of existing literature on pediatric aortic valve stenosis treatments.
• Analysis of outcomes for surgical aortic valvotomy, balloon aortic valvuloplasty, aortic valve repair techniques (leaflet extension, replacement, reconstruction), Ozaki technology, Ross procedure, mechanical valves, and biological valves.
• Comparison of early and long-term efficacy, reoperation rates, and quality of life.

Main Results:

• SAV demonstrates better long-term follow-up compared to BAV, though initial efficacy is similar.
• Aortic valve repair techniques show promise for complex cases.
• Ozaki technology offers standardization, while the Ross procedure provides good hemodynamics and low reoperation rates.
• Mechanical valves lead to reduced quality of life due to anticoagulation, and biological valves show early failure in children.

Conclusions:

• Treatment for pediatric aortic valve stenosis is evolving beyond SAV and BAV.
• Aortic valve repair and novel replacement techniques like Ozaki and Ross procedures offer promising alternatives.
• Careful consideration of long-term outcomes, patient quality of life, and reintervention rates is crucial for selecting the optimal treatment.