HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lawson, R. M. Articles by Starr, A. Search for Related Content PubMed PubMed Citation Articles by Lawson, R. M. Articles by Starr, A.

The Journal of Thoracic and Cardiovascular Surgery, Vol 71, 334-341, Copyright © 1976 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Late results of surgery for left ventricular outflow tract obstruction in children

RM Lawson, LI Bonchek, V Menashe and A Starr

Forty-four patients, with a mean age at surgery of 10 years, were followed for 5 to 16 years (mean 9.7 years) after relief of left ventricular outflow tract obstruction. There were no early deaths, but 5 late deaths occurred, 3 following reoperation. Twenty-five patients were recatheterized from 1 to 16 years later (mean 6.6 years). In 21 of 32 patients (66 per cent), a new diastolic murmur followed relief of valvular stenosis; 25 (78 per cent) of these patients had a postoperative diastolic murmur. Seventeen of these 25 (68 per cent) were recatheterized, and 11 of the 17 (65 per cent) had moderate-to- severe aortic incompetence on angiography. Eight patients (18 per cent) have undergone reoperation and 9 more (20 per cent) will have to be reoperated upon soon. Although the aortic valve gradient and left ventricular stroke pressure were reduced in all obstructive types after surgery, left ventricular end-diastolic pressure significantly increased and cardiac index decreased after valvotomy. Cardiomegaly and electrocardiographic (ECG) abnormalities were present in 45 and 66 per cent, respectively, of all postoperative patients. Although 93 per cent of patients may be expected to survive and 82 per cent be reoperation free at 10 years, further surgery thereafter becomes increasingly common. Timely relief of obstruction prevents sudden death and produces excellent symptomatic improvement, but the operation is only palliative. Development of a reliable pediatric valve and ventriculo- aortic conduit may encourage earlier and more aggressive therapy.

This article has been cited by other articles:

				M. V. Ullmann, M. Gorenflo, C. Sebening, R. Lange, H. G. Jakob, H. E. Ulmer, and S. Hagl Long-term results after reconstruction of the left ventricular outflow tract by aortoventriculoplasty Ann. Thorac. Surg., January 1, 2003; 75(1): 143 - 146. [Abstract] [Full Text] [PDF]

				J. Caspi, M. N. Ilbawi, D. A. Roberson, W. Piccione Jr., D. O. Monson, and H. Najafi Extended aortic valvuloplasty for recurrent valvular stenosis and regurgitation in children J. Thorac. Cardiovasc. Surg., April 1, 1994; 107(4): 1114 - 1120. [Abstract] [Full Text]

				J. T. Walls, Z. Lababidi, and J. J. Curtis Surgical Evaluation of Percutaneous Transluminal Balloon Angioplasty and Valvuloplasty in Congenital Cardiovascular Anomalies Vascular and Endovascular Surgery, July 1, 1988; 22(4): 253 - 257. [Abstract] [PDF]