Early Surgery Outcomes in Congenital Aortic Valve Stenosis in Children: A Cross-Sectional Study

Aortic valve stenosis is a relatively common disorder, and many patients undergo surgical treatment annually. Thus, this study was designed to assess the results of aortic valve replacement in Tabriz’s referral hospital from 2006 to 2018.
Children aged 1 month to 15 years who were diagnosed with congenital aortic valve stenosis and undergone valvular surgery, were included. Based on the findings of echocardiography, the extent of remaining aortic stenosis and aortic insufficiency were evaluated and compared according to different types of surgery, immediately after the surgery and during the 6 months of follow-up. Finally, the results were analyzed comparing the morbidity and mortality of surgical methods.
Among the included patients, 73.8% had left ventricular outflow stenosis at one level, and the remaining had more than one level of stenosis. Prior to surgery, 82.2% of patients had severe ventricular outflow tract stenosis. Immediately after surgery, 91.25% of the patients had no stenosis, or showed mild stenosis. The overall mortality of the operations was 5%. Six months after surgery, only 20% of the patients showed moderate-to-severe stenosis. Web resection and myomectomy showed higher insufficiency rates, and commissurotomy showed increased insufficiency and stenosis. Benthal surgery was shown to reduce remaining rates of insufficiency. Also, a correlation was observed between the mortality rate and commissurotomy surgery. There was no significant relationship between mortality and different levels of aortic stenosis.
The overall success rate of surgery in aortic valve stenosis was acceptable. As different surgical methods implemented in aortic valve stenosis have their own specific pros and cons, regular pediatrician visits are necessary to map-out any possible future complications.