Background:
Congenital aortic stenosis (AS) in children is initially treated with operative commissurotomy (OC) or balloon valvuloplasty (BV). We compared freedom from re-intervention and long-term survival after these treatments.
Methods:
We reviewed 168 patients with congenital AS who received OC or BV in 1984-2006. Number of reinterventions, time to reintervention, and survival were compared (Kaplan-Maier).
Results:
Mean age was 4.67 (range 0-20.51) years at first intervention. First intervention was OC in 47 patients and BV in 121 patients at mean age of 6.80 (range 0-19.29) and 3.74 (range 0-20.51) years, respectively.
In the OC group, 2 received a second OC, 9 received BV and 26 aortic valve replacement (AVR) as a second intervention.
In the BV group, 22 received a second BV, 6 received OC and 21 AVR as a second intervention.
There were 16 deaths, 5 in OC and 11 in BV group during follow-up.
After OC 1, 5 and 10-year freedom from second intervention was 92.8±3.5%, 54.5±7.0% and 42.1±7.0%. After BV 1, 5 and 10-year freedom from second intervention was 79.2±3.7%, 56.2±5.0% and 50.5±5.3%.
One, 5 and 10-year survival after OC was 89.7±4.0%, 86.9±4.7% and 84.2±4.9%. One, 5 and 10-year survival after BV was 88.7±2.8%, 88.7±2.8%, 84.6±3.5%.
Conclusions:
In the first year after intervention there is a higher rate of reinterventions in the BV group. However, there were no significant differences between the OC and BV groups in survival time (log rank 0.63) or freedom from re-intervention (log rank 0.64), despite older age in the OC group.