[Long-term results of surgical management of congenital aortic stenosis]

This retrospective study and review of the literature was undertaken to assess the long term results of valvotomy in congenital aortic stenosis (AS). One hundred and seven patients, aged between 14 days and 15 years (mean: 6.2 years), were operated on between 1966 and 1989. Thirty-three cases had valvular AS, 48 discrete subvalvular AS, 10 supravalvular AS and 16 combined AS. Thirty-three patients had associated cardiac anomalies. The surgical mortality was 6.5% (3.5% in children over 2 years of age). Three patients were lost. Ninety-seven patients had a follow-up period between 6 months and 16 years (mean: 5.4 years) with an actuarial survival of 95% at the age of 15 years. There were adverse events in 39 patients: AS, aortic regurgitation, bacterial endocarditis, third-degree heart block. Thirteen patients required re-operation and 4 balloon valvuloplasty; the late mortality was 5%. We conclude that this surgery has a low surgical mortality, but must be considered as palliative in most cases.