Aortic Stenosis

Valvar aortic stenosisAortic stenosis in infants and childrenChildren is due to a congenital abnormality of the aortic valve complex, commonly associated with bicuspid or unicuspid valve morphologyMorphology. This results in a reduction in the effective valve orifice leading to obstruction to outflow, and of varying degrees of severity. The severity of aortic valve stenosis is assessed using echocardiography and can be underestimated in the presence of left ventricular dysfunction. Critical or severe aortic valve stenosis in the newborn can present with cardiovascular collapse and shock. Older childrenChildren are often asymptomatic. In many institutions balloon valvuloplastyBalloon valvuloplasty is the preferred treatment modality of choice, however surgical valvotomy is an acceptable alternative strategy. Long term outcomes are good, however repeat interventions are not uncommon, with aortic valve replacementValve replacement surgery oftenAortic valvotomy required in the long term.