Clinical Experiences of Congenital Aortic Stenosis / 대한흉부외과학회지

ABSTRACT

BACKGROUND: The aim of this study is to assess the clinical results of various procedures in congenital aortic stenosis. MATERIAL AND METHOD: From August 1987 to June 2004, 53 patients of congenital aortic stenosis underwent procedures such as percutaneous balloon valvuloplasty, aortic valvuloplasty, Ross procedure, and aortic valve replacement. The mean age of initial procedures was 8.2+/-6.0 years. Percutaneous balloon valvuloplasty was performed in sixteen patients, aortic valvuloplasty in thirty two patients, Ross procedure in nineteen patients, and aortic valve replacement in fourteen patients. The mean follow duration was 80.6+/-60 (0~207) months. RESULT: There was 15.1% (8/53) of early mortality and no late mortality. The six patients with critical aortic stenosis were died of left ventricular dysfunction in early series (before 1 year; 4 cases) and two patients died after the Ross procedure and aortic valve replacement respectively. After percutaneous balloon valvuloplasty, most patients needed reoperations (14/16). Thirteen patients needed reoperation, after aortic valvuloplasty. After Ross procedure, two patients needed reoperation due to aortic regurgitation caused by progressive aortic root dilatation. The actuarial survival rate after Ross procedure at 7 years was 90.5%. CONCLUSION: In young children before the age of one, percutaneous balloon valvuloplasty was considered as the safe initial palliative procedure. But children over one year-old, aortic valvuloplasty were the effective procedure. Ross procedure can be preformed safely with good results.