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Pediatría (Asunción)

On-line version ISSN 1683-9803

Abstract

CHIN SUH, Dong et al. Results of aortic stenosis treatment in children at a University Hospital. Pediatr. (Asunción) [online]. 2020, vol.47, n.2, pp.81-87. ISSN 1683-9803.  https://doi.org/10.31698/ped.47022020008.

Introduction:

Aortic stenosis is relatively common in children. The objective of this study was to characterize the results and clinical course of this pathology after surgical and percutaneous management.

Material and methods:

This was a retrospective study of patients aged 0 to 19 years, treated for subvalvular, valvular, and supravalvular aortic stenosis, at Hospital de Clínicas, between 1998 and 2019. Cases associated with other congenital lesions were excluded.

Results:

Twenty patients were treated, age from 3 days to 17 years, male predominance (80%). The stenosis was valvular in 65% of the cases, subvalvular 20%, supravalvular 5% and multiple in 10%. 61% of the valve recipients received percutaneous treatment, and the other surgical valvuloplasty. At follow-up, the free reoperation rate was 47% at 10 years; 50% of them have moderate to severe aortic valve regurgitation. Of the 13 cases of valve stenosis, treated percutaneously or surgically, 4 are awaiting valve replacement. Of 4 patients with subvalvular stenosis, 3 have mild aortic regurgitation and a mean gradient of 20 mmHg. Of two patients with supravalvular stenosis, one was left with significant residual stenosis. Regarding functional class, all patients are in grades 1 and 2 of the NYHA scale. There were no immediate complications in those undergoing percutaneous or surgical procedures. Two patients (10.5%) died.

Conclusions:

Aortic stenosis mainly affects the valve region, and both surgical and percutaneous treatment allow the obstruction to be relieved until the time of valve replacement.

Keywords : Aortic stenosis; insufficiency; valvuloplasty; bicuspid; dilation; pediatrics; results.

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