Aortic Stenosis (AS) is a narrowing or tightening of the aortic valve. This narrowing prevents the blood from passing through the valve effortlessly. There are several degrees of AS, mild, moderate and critical (severe). In many instances of the mild to moderate form, the child was asymptomatic, but was found to have a murmur on examination. There are three areas where the aortic valve can become stenotic.

  • Subvalvular – The narrowing is  below the aortic valve
  • Valvular – the aortic valve itself is stenotic [leaflet(s) are fused]
  • Supravalvular -  The narrowing is above the aortic valve

Surgical procedure

A heart/lung machine or medication may be required for the surgical procedure. While the surgical techniques for each of these valvular narrowing’s are different, the objective is still the same, to relieve the obstruction.

  • Subvalvular stenosis – The aorta is opened just above the valve, and the obstruction is removed from below the valve (subvalvular ring of tissue)
  • Valvular Stenosis – The aorta is opened in a similar fashion, however the valve itself is addressed.  Excision of the fused leaflet(s) with or without commisuroplasty
  • Supravalvular Stenosis – An incision is made over the affected area and  patch is sewn  to enlarge the narrowing (aortoplasty)

Postoperative Expectations

Most children do very well after the procedure. Invasive lines are present to monitor blood pressure (arterial/venous), chest tubes, pacing wires in place. Many will be on vasodilators, i.e., nitroprusside, nitroglycerin. Hemodynamic instability is not uncommon in the immediate postoperative period requiring volume support.

Expected Length of Stay

Length of stay can vary but is around 5-7 days.