The purpose of this study was to determine the immediate and long-term benefit of valvotomy in infants with isolated aortic valvular stenosis. In the past 21 years at Texas Children's Hospital and The Texas Heart Institute, 52 infants underwent aortic valvotomy. Thirteen patients were excluded from the study because of associated defects. Cardiac catheterization was performed in 32 of the 39 infants preoperatively. The peak systolic pressure gradient (PSG) across the aortic valve ranged from 60 to 125 mm Hg (mean 90.0 mm Hg). Left ventricular end-diastolic volume (LVEDV) was calculated from the angiogram in 14 patients and ranged from 9.2 to 45.0 cc. Each infant had congestive heart failure (CHF) prior to valvotomy, and the operation was performed at an average age of 10.7 weeks (range 2 days to 10 months). There were 13 (33%) early deaths with 11 occurring in the 21 infants less than 2 months of age. The size of the LVEDV also was important: The mean LVEDV was 31.6 cc ± 2.5 SEM in seven survivors compared to 17.9 ± 3.4 in seven nonsurvivors (p < 0.005). Follow-up (mean 7.2 years) of the 26 survivors showed than 24 had aortic insufficiency clinically, but the only repeat aortic valve operation necessary in the 26 was an aortic valve replacement performed at 17 years in a patient with severe aortic insufficiency.
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine