VALVOTOMY FOR ISOLATED CONGENITAL AORTIC-STENOSIS IN CHILDREN - PROGNOSTIC FACTORS FOR OUTCOME

Early and late results after surgery for isolated congenital valvar aortic stenosis were evaluated in a total of 86 children under 16 years of age (mean 7.4 years). Primary procedure was always conservative. There were 7/86 (8.1 %) early deaths. All infants who died after the operation were younger than 4 months of age. Among the clinical variables tested by the univariate analysis only age and duration of cardiopulmonary bypass were significant prognostic factors for early death. There were 6/67 (7.7 %) valve-related late deaths. Multivariate analysis could not identify any risk factors for early and late mortality. Actuarial survival was 97% (95% CL 93-101%) after 5 years, 94 % (88-100 %) after 10 years, 90 % (82-98 %) after 15 years, and 87 % (77-97 %) after 20 years. A total of 22/79 (28 %) early survivors had a first reoperation and 5 had a second reoperation. Long follow-up interval was the only significant factor for reoperation. Actuarial reoperation-free interval was 91 % (85-98 %) after 5 years, 70 % (58-81 %) after 10 years, and 50 % (34-64 %) after 15 years. Significant factors for poor valve function were long duration of follow-up, endocarditis, and young age at operation. The probability of normal valve function was 91 % (84-98 %) after 5 years, 67 % (55-79 %) after 10 years, and 54 % (40-68 %) after 15 years.