Why the study?
What are the long-term outcomes of aortic valvulotomy under hypothermia in patients with congenital aortic stenosis?
What are the long-term outcomes of aortic valvulotomy under hypothermia in patients with congenital aortic stenosis?
Aortic valvulotomy for congenital aortic stenosis improves longevity but is often the first in a series of operations, with a 20% to 40% chance of requiring reoperation after 10 years.
Answers are grounded in this paper and cite their sources.
These outcomes underscore valvulotomy as initial palliation with substantial reoperation risk; leaves open questions on optimal long-term strategies in congenital aortic stenosis.
Between 1956 and 1967, 34 patients, aged 2 months to 40 years, underwent aortic valvulotomy under hypothermia for congenital aortic stenosis. There were two early and five late deaths. Twenty-seven patients were followed up for a mean of 15 years. Thirteen patients had no subsequent operation: 11 are asymptomatic, seven with mild aortic insufficiency. Ten patients have had aortic valve replacement (AVR), one revalvulotomy, three will require AVR. Three late deaths were sudden. The literature has been reviewed for data on mortality, endocarditis, aortic insufficiency, and reoperation. Operation improves longevity, but does not restore it to normal. Aortic valve replacement in children carries a poor prognosis, possibly reflecting severity of disease. The chances of reoperation after ten years are 20% to 40%. Valvulotomy must, therefore, be regarded as the first in a possibly lifelong series of operations.
No takes yet. Share an insight, caveat, or question.
James R. Stewart (1978) studied this question.
Synapse has enriched 10 related papers. Consider them for comparative context: