Open valvotomy for aortic valve stenosis in newborns and infants

The most appropriate management of aortic stenosis in children remains controversial. Both balloon and surgical valvotomy are firmly established as effective initial treatments with encouraging survival rates even in the troublesome neonatal group. Improved early results are based rather on the better understanding of the limits of a biventricular repair than on the method of treatment. Valvotomy of any kind is a palliative procedure and reintervention remains frequent. Direct surgical intervention, where exact splitting of fused commissures and shaving off of obstructing nodules can produce a better valve with maximum valve orifice without causing regurgitation, might offer superior longer-lasting results in comparison with blind ballooning.