Mid-term results of open aortic valvotomy for infants with critical aortic stenosis: Seven-year experience including delayed Ross strategy

Junichi Koizumi, Kozo Ishino, Masaaki Kawada, Ko Yoshizumi, Kazushige Kanki, Shunji Sano

Research output: Contribution to journalArticle

Abstract

Objectives: The purpose of this study is to provide short- and mid-term results of open aortic valvotomy (OAV) for patients with critical aortic stenosis (AS). Methods: Between December 1993 and June 1996, 6 patients with critical AS underwent an OAV in our unit. Their ages and body weights at operation ranged from 1 to 65 days (median age, 9 days) and from 2.4 to 5.7 kg (median weight, 33 kg), respectively. Peak pressure gradient and diameter of the aortic valve ranged from 25 to 111 mmHg (mean value, 79 mmHg) and from 4.6 to 7.5 mm (mean diameter, 6.1 mm), respectively. OAV comprised the valvular commissurotomy and excision of the myxomatous nodules with cardiopulmonary bypass. Results: No early or late death occurred. Mean peak pressure gradient across the aortic valve was reduced to 33 mmHg (from 15 to 44 mmHg) with no aortic insufficiency in 2 patients and trivial insufficiency in 4. During the follow-up period of 6 to 9 years, 3 out of 6 patients required no reintervention. The other 3 patients required repeated valvotomy for recurrent stenosis within 0.2 to 1.3 years after the operation. Of these, 2 patients required the Ross procedure at 7 years of age or older, and another at 6 years of age awaits the Ross procedure. Conclusion: OAV for critical AS was effective without causing mortality or significant aortic insufficiency. Our current strategy comprising the initial OAV and "delayed Ross procedure" for recurrent stenosis with or without insufficiency is a promising therapeutic option for infants with critical AS.

Original languageEnglish
Pages (from-to)593-597
Number of pages5
JournalJapanese Journal of Thoracic and Cardiovascular Surgery
Volume53
Issue number11
Publication statusPublished - Nov 2005

Fingerprint

Aortic Valve Stenosis
Aortic Valve
Pathologic Constriction
Pressure
Cardiopulmonary Bypass
Body Weight
Weights and Measures
Mortality

Keywords

  • Critical aortic stenosis
  • Open aortic valvotomy
  • Ross procedure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Mid-term results of open aortic valvotomy for infants with critical aortic stenosis : Seven-year experience including delayed Ross strategy. / Koizumi, Junichi; Ishino, Kozo; Kawada, Masaaki; Yoshizumi, Ko; Kanki, Kazushige; Sano, Shunji.

In: Japanese Journal of Thoracic and Cardiovascular Surgery, Vol. 53, No. 11, 11.2005, p. 593-597.

Research output: Contribution to journalArticle

Koizumi, Junichi ; Ishino, Kozo ; Kawada, Masaaki ; Yoshizumi, Ko ; Kanki, Kazushige ; Sano, Shunji. / Mid-term results of open aortic valvotomy for infants with critical aortic stenosis : Seven-year experience including delayed Ross strategy. In: Japanese Journal of Thoracic and Cardiovascular Surgery. 2005 ; Vol. 53, No. 11. pp. 593-597.
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N2 - Objectives: The purpose of this study is to provide short- and mid-term results of open aortic valvotomy (OAV) for patients with critical aortic stenosis (AS). Methods: Between December 1993 and June 1996, 6 patients with critical AS underwent an OAV in our unit. Their ages and body weights at operation ranged from 1 to 65 days (median age, 9 days) and from 2.4 to 5.7 kg (median weight, 33 kg), respectively. Peak pressure gradient and diameter of the aortic valve ranged from 25 to 111 mmHg (mean value, 79 mmHg) and from 4.6 to 7.5 mm (mean diameter, 6.1 mm), respectively. OAV comprised the valvular commissurotomy and excision of the myxomatous nodules with cardiopulmonary bypass. Results: No early or late death occurred. Mean peak pressure gradient across the aortic valve was reduced to 33 mmHg (from 15 to 44 mmHg) with no aortic insufficiency in 2 patients and trivial insufficiency in 4. During the follow-up period of 6 to 9 years, 3 out of 6 patients required no reintervention. The other 3 patients required repeated valvotomy for recurrent stenosis within 0.2 to 1.3 years after the operation. Of these, 2 patients required the Ross procedure at 7 years of age or older, and another at 6 years of age awaits the Ross procedure. Conclusion: OAV for critical AS was effective without causing mortality or significant aortic insufficiency. Our current strategy comprising the initial OAV and "delayed Ross procedure" for recurrent stenosis with or without insufficiency is a promising therapeutic option for infants with critical AS.

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