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Aortic Valve Repair in Pediatric Patients: 30 Years Single Center Experience

Johanna Schlein1, Alexandra Kaider2, Harald Gabriel3

  • 1Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.

The Annals of Thoracic Surgery
|July 2, 2022
PubMed

Insights

Pediatric aortic valve repair offers a successful long-term solution for congenital heart disease, with good survival rates and a repair-first strategy proving effective. Longevity outcomes were similar for both simple and complex aortic valve reconstruction techniques.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Valve repair is the preferred treatment for congenital aortic valve disease.
  • Surgical techniques for aortic valve repair have advanced over time.
  • This study reviews 30 years of pediatric aortic valve repair experience.

Purpose of the Study:

  • To evaluate the long-term outcomes of pediatric aortic valve repair.
  • To assess survival rates and the need for reoperations.
  • To support a repair-first strategy for congenital aortic valve disease.

Main Methods:

  • Retrospective review of 126 pediatric patients (<18 years) undergoing aortic valve repair (May 1985-April 2020).
  • Mortality data cross-checked with national health insurance database.
  • Primary endpoints: survival and reoperation incidence.

Main Results:

  • Early mortality was 5.6%, primarily in neonates with critical aortic stenosis.
  • No early deaths observed after 2002.
  • 30-year estimated survival: 83.5%. Cumulative incidence of aortic valve replacement at 30 years: 67.4%. Nine patients required re-repair; most replacements were Ross procedures.

Conclusions:

  • A repair-first strategy is supported for congenital heart disease.
  • Aortic valve reconstruction can be a successful long-term solution.
  • Longevity did not differ between simple commissurotomy and complex reconstruction.
Abstract

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