Original articleCardiovascularOutcome of Surgical Commissurotomy for Aortic Valve Stenosis in Early Infancy
Section snippets
Patients and Methods
This was a retrospective study of all patients who underwent operation because of aortic valve stenosis within the first 3 months of life at our institution from 1991 until 2004. The patients’ files were reviewed for data, including echocardiographic findings preoperatively, perioperatively, direct postoperatively, 6 to 12 months postoperatively, and at the patient’s last follow-up visit at the referring cardiologist. The study period ended in July 2005. Follow-up time was a median of 4.1 years
Mortality
The study period was divided into three time intervals: 1991 to 1995, 1996 to 2000, and 2001 to 2004. Figures for early mortality (within 30 days postoperatively) and late mortality are presented in Table 1. During the whole study period, the early mortality rate was 3 (5%) of 64 patients:
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In 1991, a 63-day-old girl presented with tachypnea and poor left ventricular function. Inotropic support was initiated and she received mechanical ventilation before undergoing open commissurotomy.
Comment
Significant aortic valve stenosis in the newborn is a serious condition with high mortality in older series. This study shows that open commissurotomy in the neonate can currently be done with low mortality. Other centers also report very low or no early mortality in this group of patients treated surgically [2, 3], but with increased risk in patients with other associated cardiac lesions [4]. As other authors have suggested [5], one reason for a better outcome during the last decade, both
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