Congenital Heart Surgery

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Outcomes Following Aortic Valve Repair and Replacement in Children

Surgical treatment of aortic valve (AV) diseases in childhood involves complex decisions, particularly in very small patients, and there is no consensus regarding the optimum surgical option. We recently reviewed our outcomes following aortic valve repair and replacement in children.

Depictions of modes of aortic valve dysfunction that may be surgically correctable including cusp restriction and prolapse.

In the setting of a subaortic ventricular septal defect, the associated aortic valve cusp may be subject to distortion and prolapse related to turbulent flow. The corresponding cusp elongation and prolapse may progress to significant aortic valve incompetence.

In the setting of severe aortic valve cusp distortion, symmetric leaflet reduction may be required as noted in this illustration. Subcommissural sutures also aid in improving the zone of coaptation with adjacent cusps.

1Average follow-up time was 4 years (range: 8 days to 5 years.)