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Ann Thorac Surg 1985;40:156-162
© 1985 The Society of Thoracic Surgeons

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Articles

Reoperation in Congenital Aortic Stenosis

From the Departments of Surgery, Section of Cardiothoracic Surgery, and Pediatric Cardiology, University of Oklahoma College of Medicine, Oklahoma City, OK.

^* Address reprint requests to Dr. Elkins, Oklahoma Teaching Hospitals, PO Box 26307, Oklahoma City, OK 73126

Over a 22-year period, 81 patients underwent initial operations for critical aortic stenosis at our institution. Their ages ranged from 3 days to 20 years (mean, 7.3 ± 5.9 years). Fourteen (17%) were infants less than 1 year old. Three children died perioperatively (3.7%). We have followed the survivors and 3 children who underwent initial operations elsewhere for a mean of 9.0 ± 6.8 years (range, 2 to 23 years). To the present, 27 patients have undergone one reoperation (24 of our initial survivors) at a mean interval of 7.3 years, with 2 perioperative deaths. Ten of these patients have required a second reoperation at a mean interval of 3.7 years, with 2 deaths perioperatively. There were 3 late cardiac deaths after the initial procedure and 1 after a third operation. Actuarial reoperation-free survival is 56.7% at 10 years. While overall survival is 88.6% at 10 years, we find a significantly poorer survival among those patients with valvular stenosis compared with those with subvalvular lesions (p = 0.03). We believe that for children with all levels of aortic stenosis, good functional results and survival can best be obtained by follow-up, recatheterization, and reoperation.

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