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Ten to 22 Years After Valvulotomy

James R. Stewart, MD; Bruce C. Paton, MRCP, FRCS(E); S. Gilbert Blount, Jr, MD; Henry Swan, MD

Arch Surg. 1978;113(11):1248-1252.

Abstract
• Between 1956 and 1967, 34 patients, aged 2 months to 40 years, underwent aortic valvulotomy under hypothermia for congenital aortic stenosis. There were two early and five late deaths. Twenty-seven patients were followed up for a mean of 15 years. Thirteen patients had no subsequent operation: 11 are asymptomatic, seven with mild aortic insufficiency. Ten patients have had aortic valve replacement (AVR), one revalvulotomy, three will require AVR. Three late deaths were sudden.

The literature has been reviewed for data on mortality, endocarditis, aortic insufficiency, and reoperation. Operation improves longevity, but does not restore it to normal. Aortic valve replacement in children carries a poor prognosis, possibly reflecting severity of disease. The chances of reoperation after ten years are 20% to 40%. Valvulotomy must, therefore, be regarded as the first in a possibly lifelong series of operations.

(Arch Surg 113:1248-1252, 1978)

Author Affiliations
From the Departments of Surgery (Drs Stewart, Paton, and Swan) and Medicine (Dr Blount), University of Colorado Medical Center, Denver.

Footnotes
Accepted for publication July 28, 1978.

Presented at the 26th scientific meeting of the International Cardiovascular Society, Los Angeles, June 23, 1978.

Reprint requests to University of Colorado Medical Center, 4200 E 9th Ave, Denver, CO 80262 (Dr Paton).

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