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Long-term outcomes of aortic valve repair in children after infancy

Michael Z L Zhu1, Igor E Konstantinov2, Tyson A Fricke1

  • 1Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia.

The Journal of Thoracic and Cardiovascular Surgery
|February 18, 2026
PubMed

Insights

Aortic valve (AoV) repair in children after infancy demonstrates good long-term survival. Initial AoV repair allows most children to avoid prosthetic valve replacement until adulthood.

Area of Science:

  • Pediatric Cardiology
  • Cardiac Surgery
  • Congenital Heart Disease Management

Background:

  • Evaluating long-term outcomes of aortic valve (AoV) repair in children older than one year.
  • Assessing the efficacy of primary AoV repair in pediatric patients.

Purpose of the Study:

  • To determine the long-term results of aortic valve repair in children who underwent the procedure after infancy.
  • To identify factors influencing the need for reoperation or replacement after initial AoV repair.

Main Methods:

  • Retrospective study of 326 patients aged ≥1 year undergoing primary AoV repair (1980-2024).
  • Analysis of early and late mortality, survival rates, and freedom from reoperation/replacement.
  • Identification of independent risk factors for aortic valve replacement (AVR).

Main Results:

  • Median follow-up was 9.04 years; 10, 15, and 20-year survival was 98.4%, 97.9%, and 94.9%.
  • 15-year freedom from AoV reoperation was 59.1%, and from AVR was 65.7%.
  • Risk factors for AVR included prior balloon valvuloplasty, use of CardioCel patch, and subcommissural annuloplasty.

Conclusions:

  • Aortic valve repair in children after infancy offers favorable long-term outcomes with high survival rates.
  • Initial AoV repair defers the need for prosthetic valve replacement into adulthood for most patients.
  • Subsequent procedures often involved Ross operations or redo AoV repairs.
Abstract

Keywords:
aortic valve repairaortic valve replacementcongenital aortic valve diseasecongenital heart disease

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