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The journey from repair to replacement in pediatric aortic valve stenosis: a 10-year single-center experience

Guowei Zeng1, Xinjie Zhang1, Longming Huang1

  • 1Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai, 200127, China.

BMC Pediatrics
|January 9, 2026
PubMed

Insights

Pediatric congenital aortic stenosis (AS) patients often need reoperation within 10 years of initial aortic valve (AoV) repair. AoV replacement during reoperation offers better long-term outcomes than repair for these children.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Congenital Heart Disease

Background:

  • Congenital aortic stenosis (AS) requires timely intervention.
  • Long-term outcomes and reoperation strategies for pediatric AS after initial aortic valve (AoV) repair are not fully understood.

Purpose of the Study:

  • To evaluate reintervention outcomes and long-term prognosis in pediatric patients with isolated AS following their initial AoV repair.
  • To compare the effectiveness of different reoperation strategies.

Main Methods:

  • Retrospective analysis of clinical data from 203 pediatric patients with isolated AS who underwent initial AoV repair (2013-2024).
  • Primary outcome: freedom from reoperation.
  • Secondary outcomes: freedom from AoV replacement, freedom from moderate or greater AS/aortic regurgitation.

Main Results:

  • The 10-year freedom from AoV reoperation rate was 50.9%.
  • The 10-year freedom from AoV replacement rate was 62.7%.
  • AoV replacement during reoperation showed superior long-term outcomes compared to secondary AoV repair (P=0.001).

Conclusions:

  • Initial AoV repair for pediatric AS yields favorable outcomes, but nearly half of patients require reoperation within a decade.
  • AoV replacement is associated with better long-term quality of life for reoperations in pediatric AS patients.
Abstract

Keywords:
Aortic valve repairAortic valve replacementPediatric aortic valve stenosisReoperationRoss procedure

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