children s health issues
Aortic Valve Stenosis in Children
Treatment of Aortic Valve Stenosis in Children
Surgery to widen or replace the valve Cardiac catheterization with balloon valvuloplasty (using a balloon at the end of a catheter to widen the stiffened valve) In infants with severe aortic valve stenosis, doctors may need to immediately give a medication, a prostaglandin, that will reopen or keep open the ductus arteriosus, a blood vessel that connects the pulmonary artery and the aorta (see also Normal Fetal Circulation ). Normally, the ductus arteriosus closes soon after birth. A widely opened ductus can temporarily help supply blood to the body when too little is getting through the tight aortic valve. The medication is given by vein (intravenously). Urgent surgery or balloon valvuloplasty is needed soon after diagnosis. For children with severe narrowing or symptoms, the aortic valve must be widened or replaced. Widening the valve can be done during Cardiac Catheterization and Coronary Angiography by a procedure called balloon valvuloplasty, or by surgery. For balloon valvuloplasty, a thin tube (catheter) with a balloon at its tip is passed through a blood vessel in the groin into the narrowed valve. The balloon is inflated and used to stretch the narrowed opening of the valve. Surgery is needed instead of a catheterization procedure when the valve is unusually small or is both leaky and narrowed. Surgery is also done if the child has additional heart problems that must be treated surgically. It is desirable to fix the valve if possible. If the valve cannot be fixed, it can be replaced with a metal artificial valve, with a tissue valve, or with the child's own good pulmonary valve (this is called the Ross procedure). Children with a metal artificial valve must take an anticoagulant medication, such aswarfarin, to prevent blood clots from forming. Children who have valve replacement need to take antibiotics before visits to the dentist and before certain surgeries (such as on the respiratory tract). These antibiotics are used to prevent a serious heart infection called Infective Endocarditis . 