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Treatment of valvular aortic stenosis in children: a 20-year experience in a single institution

Artikel i vetenskaplig tidskrift
Författare Cecilia Kjellberg Olofsson
Håkan Berggren
Björn Söderberg
Jan Sunnegårdh
Publicerad i Interactive Cardiovascular and Thoracic Surgery
Volym 27
Nummer/häfte 3
Sidor 410-416
ISSN 1569-9293
Publiceringsår 2018
Publicerad vid Institutionen för kliniska vetenskaper
Sidor 410-416
Språk en
Länkar dx.doi.org/10.1093/icvts/ivy078
Ämnesord Congenital valvular aortic stenosis , Surgical valvotomy , Outcome
Ämneskategorier Thoraxkirurgi, Kardiovaskulär medicin

Sammanfattning

OBJECTIVES This study presents short- and long-term follow-up after treatment for isolated valvular aortic stenosis in children with surgical valvotomy as the preferred 1st intervention. METHODS All patients aged 0–18 years treated between 1994 and 2013 at our centre were reviewed regarding the mode of first treatment, mortality, reinterventions and the need for aortic valve replacement. RESULTS A total of 113 patients were identified in local registries. There were 44 neonates, 31 infants and 38 children. The mean follow-up period was 11 years (range 2–22 years). No early deaths and only 2 late deaths were reported. Of the 113 patients, 92 patients had open surgical valvotomy as the 1st intervention. Freedom from reintervention was 80%, 69%, 61%, 57% and 56% at 1, 5, 10, 15 and 20 years, respectively. The main indication for reintervention was valvular stenosis. Freedom from aortic valve replacement was 67%. CONCLUSIONS Surgical valvotomy of aortic stenosis in this long-term follow-up study resulted in no 30-day mortality and <1% late mortality. Reinterventions were common, with 38% of the patients having further surgery or catheter treatment of the aortic valve before the age of 18 years. Among the 40 patients aged 18 years or older at follow-up, 45% had had the aortic valve replaced. Our data do not allow comparison of catheter and surgical treatment, but, based on these results, we find no reason to change our current policy of surgical treatment as 1st intervention in patients with isolated valvular aortic stenosis.

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