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Paediatric Cardiology

Congenital aortic valve stenosis occurs due to thickening of the valve and commissural splicing. The prevalence of aortic stenosis is 2.4 per 10.000 live births, with male to female ratio of 3-4:1. In most cases, this defect is associated with bicuspid aortic valve. Associative structural heart abnormalities are registered in 20% of patients (persistent ductusarteriosus, coarctation, ventricular septal defect, etc). Prognosis is determined by the degree of stenosis, which depend on the transvalvular pressure gradient can be mild (<50 mm Hg), moderate (50-75 mm Hg) and severe (>75 mm Hg). There are two clinical forms of the disease: classical form (90% of patients) and neonatal critical congenital valvular aortic stenosis (10% of patients). One third of patients needs treatment, either percutaneous transcatheter balloon dilatation or surgical commissurotomy. These interventions prevent progressive heart dysfunction, and treated children have long-term reintervention-free survival. There is limited number of well-designed long-term studies thatpermits appropriate comparison of balloon dilation and surgical treatment. Therefore, there still is no consensus concerning the initial approach in patients with aortic stenosis. In the previous reports both comparable results and much more favorablesurgical results were presented. Our 26.5 years’ experience in treating 62 not critical aortic stenosis patients, out of newborn period, showed very comparable both early and late follow up resultsafter balloon dilation and surgical commissurotomy. Additional studies on this topic are required for establishing consensus about the initial approach. Sergej Prijic, Congenital aortic valve stenosis in children- Initial treatment options
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Last date updated on June, 2014

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