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Repeat aortic valvotomy in children.

D R Fulton, T J Hougen, J F Keane

    American Heart Journal
    |July 1, 1983
    PubMed
    Summary
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    Repeat aortic valvotomy outcomes were reviewed in 13 children with congenital valvar aortic stenosis. Results suggest repeat procedures may not significantly improve hemodynamics in patients not operated on early in life.

    Area of Science:

    • Pediatric Cardiology
    • Cardiac Surgery
    • Congenital Heart Disease

    Background:

    • Congenital valvar aortic stenosis is a significant pediatric cardiac condition.
    • Repeat valvotomy is sometimes performed for residual obstruction after initial intervention.

    Purpose of the Study:

    • To review the outcomes of repeat aortic valvotomy in children with congenital valvar aortic stenosis.
    • To assess the hemodynamic improvement following repeat valvotomy.

    Main Methods:

    • Retrospective review of 13 children undergoing repeat aortic valvotomy.
    • Analysis of hospital mortality, late death, and post-procedure cardiac catheterization data.
    • Evaluation of peak systolic ejection gradient and aortic regurgitation.

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    Main Results:

    • No hospital mortality observed; one late death (8%) occurred.
    • Three children (infants at initial surgery) had favorable outcomes (gradient ≤40 mm Hg, mild regurgitation).
    • Seven children had persistent obstruction or moderate/severe regurgitation, with varied ages at initial surgery.

    Conclusions:

    • Repeat aortic valvotomy outcomes vary in children with congenital valvar aortic stenosis.
    • Early intervention in infancy may be a predictor of better results after repeat valvotomy.
    • Repeat valvotomy may not significantly improve hemodynamic status in older children or those not operated on early in life.