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Outcome of surgical commissurotomy for aortic valve stenosis in early infancy

Rehnström, Pia; Malm, Torsten LU ; Jögi, Peeter LU ; Fernlund, Eva; Winberg, Per; Johansson, Jens LU and Johansson, Sune LU (2007) In Annals of Thoracic Surgery 84(2). p.594-598
Abstract
Background. The method of treatment of aortic valve stenosis in early infancy is still controversial. This study was performed to evaluate short-term and long-term outcome in our center during a 14-year period. Methods. Between 1991 and 2004, 64 consecutive patients younger than 3 months old underwent open surgical commissurotomy because of aortic valve stenosis. Median age was 18 days ( range, 1 to 79 days), and median weight was 3.6 kg ( range, 1.9 to 6.7 kg). Left ventricular function was good in 44 patients (69%), depressed in 12 (19%), and poor in 8 (12%). The study ended in July 2005. Median follow-up time was 4.1 years ( range, 0.4 to 13.6 years). Results. The 30-day mortality was 3 of 64 patients and late mortality was 3 of 61, and... (More)
Background. The method of treatment of aortic valve stenosis in early infancy is still controversial. This study was performed to evaluate short-term and long-term outcome in our center during a 14-year period. Methods. Between 1991 and 2004, 64 consecutive patients younger than 3 months old underwent open surgical commissurotomy because of aortic valve stenosis. Median age was 18 days ( range, 1 to 79 days), and median weight was 3.6 kg ( range, 1.9 to 6.7 kg). Left ventricular function was good in 44 patients (69%), depressed in 12 (19%), and poor in 8 (12%). The study ended in July 2005. Median follow-up time was 4.1 years ( range, 0.4 to 13.6 years). Results. The 30-day mortality was 3 of 64 patients and late mortality was 3 of 61, and the respective mortality in patients younger than 1 month old was 2 of 41 and 2 of 39. There was no early mortality after 1993 and no late mortality after 1999. Thirteen patients required reoperation. Median time to reoperation was 4.3 years ( range, 0.2 to 11.3 years) and to aortic valve replacement ( 7 Ross and 1 homograft) was 6.9 years ( range, 1.6 to 9.7 years). At the last follow-up, all had good left ventricular function and 57 of 58 had an ability index of 1. Conclusions. Surgical commissurotomy for aortic valve stenosis during the first 3 months of life can be done with low mortality and morbidity. The risk for early recurrent stenosis or regurgitation is low, and the need for aortic valve replacement can, in most cases, be delayed until the child is older. The long-term functional ability is excellent. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Thoracic Surgery
volume
84
issue
2
pages
594 - 598
publisher
Elsevier
external identifiers
  • wos:000248192400034
  • scopus:34447567163
ISSN
1552-6259
DOI
10.1016/j.athoracsur.2007.03.098
language
English
LU publication?
yes
id
e0f799b0-ef76-469b-88f6-86b8ca551e92 (old id 645987)
alternative location
http://ats.ctsnetjournals.org/cgi/content/abstract/84/2/594
date added to LUP
2007-12-18 11:04:41
date last changed
2017-01-01 05:11:41
@article{e0f799b0-ef76-469b-88f6-86b8ca551e92,
  abstract     = {Background. The method of treatment of aortic valve stenosis in early infancy is still controversial. This study was performed to evaluate short-term and long-term outcome in our center during a 14-year period. Methods. Between 1991 and 2004, 64 consecutive patients younger than 3 months old underwent open surgical commissurotomy because of aortic valve stenosis. Median age was 18 days ( range, 1 to 79 days), and median weight was 3.6 kg ( range, 1.9 to 6.7 kg). Left ventricular function was good in 44 patients (69%), depressed in 12 (19%), and poor in 8 (12%). The study ended in July 2005. Median follow-up time was 4.1 years ( range, 0.4 to 13.6 years). Results. The 30-day mortality was 3 of 64 patients and late mortality was 3 of 61, and the respective mortality in patients younger than 1 month old was 2 of 41 and 2 of 39. There was no early mortality after 1993 and no late mortality after 1999. Thirteen patients required reoperation. Median time to reoperation was 4.3 years ( range, 0.2 to 11.3 years) and to aortic valve replacement ( 7 Ross and 1 homograft) was 6.9 years ( range, 1.6 to 9.7 years). At the last follow-up, all had good left ventricular function and 57 of 58 had an ability index of 1. Conclusions. Surgical commissurotomy for aortic valve stenosis during the first 3 months of life can be done with low mortality and morbidity. The risk for early recurrent stenosis or regurgitation is low, and the need for aortic valve replacement can, in most cases, be delayed until the child is older. The long-term functional ability is excellent.},
  author       = {Rehnström, Pia and Malm, Torsten and Jögi, Peeter and Fernlund, Eva and Winberg, Per and Johansson, Jens and Johansson, Sune},
  issn         = {1552-6259},
  language     = {eng},
  number       = {2},
  pages        = {594--598},
  publisher    = {Elsevier},
  series       = {Annals of Thoracic Surgery},
  title        = {Outcome of surgical commissurotomy for aortic valve stenosis in early infancy},
  url          = {http://dx.doi.org/10.1016/j.athoracsur.2007.03.098},
  volume       = {84},
  year         = {2007},
}