SURGICAL THERAPY FOR CONGENITAL AORTIC VALVULAR STENOSIS - A 23 YEAR EXPERIENCE

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  • 1 January 1983
    • journal article
    • research article
    • Vol. 85  (1) , 41-48
Abstract
Consecutive patients (70) (2-20 yr old) are reviewed who underwent valvotomy for congenital aortic valvular stenosis from 1958-1980. A tricuspid valve was created in 36, a bicuspid valve in 33 and a valve prosthesis was inserted in 1, with 2 operative deaths (2.8%). There were 4 late deaths, 3 due to noncardiac causes. Eleven patients required reoperation from 2-21 yr (mean 11.3 yr) after valvotomy, with 2 deaths. Seven patients underwent valve replacement. One patient died 9 yr after a 2nd valvotomy. The overall survival rate including reoperation was 92.6% for 10 yr and 86% for 15 yr. Of 53 surviving patients free of reoperation, 49 are in New York Heart Association class I and 4 are in class II. One of the patients in class II is a candidate for reoperation. The other 52 patients are well; 23 have normal stress tests, and only 1 of 24 studied has a pressure gradient > 50 mm Hg. Apparently, valvotomy effectively and safely relieves left ventricular outflow tract (LVOT) obstruction produced by congenital aortic valvular stenosis. It delays the time when a prosthetic device will be required to relieve LVOT obstruction.