Congenital Aortic Stenosis and Its Surgical Treatment

The purpose of this paper is to assess the place and timing of surgery in the treatment of aortic stenosis of congenital origin. The diagnosis of aortic stenosis is readily made at the bedside and the clinical features are well known (Levine, 1945; Kiloh, 1950; Campbell and Kauntze, 1953). Its congenital origin is more difficult to substantiate. In the hope of excluding cases of acquired stenosis, we consider here only those patients in whom heart disease was recognized in infancy, or, at latest, on their first routine school medical examination at about five years of age, or in whom the site of stenosis was sub-aortic. Twenty-eight such patients form the basis of this review (Table The length of follow-up extended in some instances to ten years and, excluding two infants, averaged nearly four years. Aortic incompetence was also present in six patients and the adult type of coarctation of the aorta in three others. Five patients died as a result of the lesion during the period of follow-up; two in infancy, two before puberty, and one in his middle teens. In six others the stenosis was considered sufficiently severe to justify aortic valvotomy.