Outcomes of uncomplicated aortic valve stenosis presenting in infants

American Heart Journal
Shaul BaramDavid G Nykanen

Abstract

The management of uncomplicated aortic valve stenosis presenting with critical obstruction in infants continues to be associated with significant morbidity and mortality. However, not all infants have critical obstruction, and outcomes spanning the broader spectrum of disease severity are less well defined. In a 12-year period, 55 infants (<3 months of age) were seen with aortic valve stenosis and with anatomy suitable for biventricular repair. Clinical, echocardiographic, angiographic, management, and outcome data were reviewed. Status at presentation (median age 6 days) included signs of congestive heart failure in 20 patients, cardiovascular collapse in 5 patients, and an asymptomatic heart murmur in 30 patients. The initial echocardiogram showed reduced left ventricular function in 26% of patients, with a mean peak instantaneous gradient of 69 +/- 30 mm Hg in patients with normal function. There were 5 deaths (9%), all in patients with poor ventricular function. The initial intervention was balloon valvotomy in 24 patients and surgical valvotomy in 20 patients, with 11 patients having no intervention to date. The freedom-from-intervention rate was 69% at age 1 week, 58% at 1 month, 36% at 3 months, and 28% at 1 year. Patien...Continue Reading

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Citations

Jul 30, 2015·Congenital Heart Disease·Rohit S LoombaAndrew N Pelech
Jul 24, 2007·The Annals of Thoracic Surgery·Pia RehnströmSune Johansson
Nov 7, 2006·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Jaspal S DuaRobin P Martin
Aug 21, 2013·The Journal of Thoracic and Cardiovascular Surgery·Muhammad S KhanCharles D Fraser
Sep 27, 2005·Expert Review of Cardiovascular Therapy·Nigel E DruryLee N Benson
Apr 8, 2006·Current Opinion in Cardiology·Kelly M McLeanJeffrey M Pearl
Feb 1, 2005·Cardiology in the Young·Carlos A C PedraLee N Benson

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