Related Experiment Video

Updated: Aug 12, 2026

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
12:17

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

Published on: May 21, 2017

Prognostic factors in valvotomy for critical aortic stenosis in infancy

S R Gundry, D M Behrendt

    The Journal of Thoracic and Cardiovascular Surgery
    |October 1, 1986
    PubMed

    Insights

    Infants with critical aortic stenosis can benefit from aortic valvotomy, even with impaired cardiac function. This procedure improves hemodynamics and outcomes, despite initial high mortality risks in critical aortic stenosis infant cases.

    Area of Science:

    • Pediatric Cardiology
    • Cardiac Surgery
    • Neonatal Critical Care

    Background:

    • Critical aortic stenosis in infancy presents a significant challenge with historically high mortality rates.
    • Early intervention is crucial, but the impact of preoperative cardiac function on survival post-aortic valvotomy is not fully understood.

    Purpose of the Study:

    • To identify preoperative factors influencing survival in infants undergoing aortic valvotomy for critical aortic stenosis.
    • To evaluate the long-term hemodynamic outcomes and need for reintervention after aortic valvotomy in this population.

    Main Methods:

    • Retrospective review of 24 infants who underwent aortic valvotomy within the first six months of life between 1978 and 1984.
    • Analysis of preoperative clinical data, including ejection fraction, left ventricular end-diastolic pressure, endocardial fibroelastosis, peak systolic gradient, and left ventricular end-diastolic volume.
    • Assessment of operative mortality, long-term follow-up data, including cardiac catheterization results and need for surgical reintervention.

    Main Results:

    • Operative mortality was 21%, with low cardiac output being the primary cause of death.
    • Preoperative factors predicting poor outcome included low ejection fraction, high left ventricular end-diastolic pressure, and presence of endocardial fibroelastosis.
    • Long-term follow-up in recatheterized patients showed significant improvement in ejection fraction and left ventricular end-diastolic volume, with most patients remaining asymptomatic.

    Conclusions:

    • Infants with critical aortic stenosis can benefit from aortic valvotomy, even with impaired left ventricular function and reduced ventricular dimensions.
    • The procedure can lead to nearly normal hemodynamics on late follow-up, suggesting a favorable risk-benefit profile for selected infants.
    • While certain preoperative factors indicate higher risk, aortic valvotomy remains a viable option for improving outcomes in infantile critical aortic stenosis.

    More Related Videos

    Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement14:14

    Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

    Published on: December 11, 2017

    A Rodent Model of The Ross Operation: Syngeneic Pulmonary Artery Graft Implantation in A Systemic Position11:20

    A Rodent Model of The Ross Operation: Syngeneic Pulmonary Artery Graft Implantation in A Systemic Position

    Published on: April 1, 2022

    Related Concept Videos

    Mitral Stenosis I: Introduction01:22

    Mitral Stenosis I: Introduction

    Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
    Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

    Mitral Stenosis II: Clinical features and Diagnostic Tests

    Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
    Mitral Stenosis III: Medical Management01:26

    Mitral Stenosis III: Medical Management

    Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
    Mitral Stenosis IV: Nursing Management01:27

    Mitral Stenosis IV: Nursing Management

    A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
    Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

    Aortic Regurgitation II: Clinical Features and Diagnostic Tests

    Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
    Aortic Regurgitation III: Medical Management01:25

    Aortic Regurgitation III: Medical Management

    Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...