Abstract
The aim of the study was to analyze the immediate and mid-term results of correction of isolated valvular aortic stenosis in children of the first year of life.
Material and methods. The retrospective study included neonatal and infant patients who received cardiac surgery from 2021 to 2024 at the Cardiac Surgery Department No. 1 (Children’s) of the Bakulev National Research Medical Center for Congenital isolated valvular aortic stenosis.
Results. The median age was 26.5 days. Newborns – 30 (48.4%), infants – 32 (51.6%). Of these, 45 (72.6%) are male and 17 (27.4%) are female (2.6:1 ratio). Body weight Me – 4.05, body surface area from 0.14 to 0.44 m2 (Me – 0.25). The first group consisted of 22 (35.4%) patients whose valve reconstruction was performed using an autopericardium. Freedom from repeated interventions within 35 months was 68% [62.4–73.3], the second group consisted of 40 (64.6%) patients. Basically, the anatomy was represented by a bicuspid structure – in 33 cases (82.5%). The freedom from repeated interventions was 96% [45,2–99,3]. When using an autopericardium, the risk of residual valve stenosis is 4.625 (95% confidence interval (CI) 1.027–20.822) times. The presence of signs of fibroelastosis also increased the chances of aortic valve stenosis by 15.05 times (95% CI 2.707–83.6).
Conclusion. Open interventions on the aortic valve in children are safe and effective. The morphology of the valve largely determines the type of surgical intervention. It is often not possible to reliably reconstruct the valve without the use of additional plastic materials. The lack of ideal material, as well as the “gold” standard in this age group, is an incentive to find a solution to an urgent problem.
About the authors
- Erik A. Shakhnazaryan, Cardiovascular Surgeon; ORCID
- Aleksey E. Chernogrivov, Dr. Med. Sci., Senior Researcher; ORCID
- Inessa E. Nefedova, Dr. Med. Sci., Head of Department; ORCID
- Anna M. Vaneeva, Researcher; ORCID
- Zera A. Kodzokova, Anesthesiologist-Intensivist; ORCID
- Arina P. Sidorenko, Student; ORCID
- Alina S. Sarkisyan, Pediatric Cardiologist; ORCID
