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NATURAL HISTORY OF CONGENITAL ISOLATED MILD AORTIC VALVE AND MILD PULMONARY VALVE STENOSIS: A SINGLECENTER FOLLOW-UP STUDY

Year 2022, Volume: 85 Issue: 2, 242 - 248, 24.03.2022
https://doi.org/10.26650/IUITFD.1027281

Abstract

Objective: Most of the available information on the natural history of aortic stenosis (AS) and pulmonary stenosis (PS) in children is based on studies carried out over the past 35-40 years using cardiac catheterization. This study aimed to reveal the natural history of congenital isolated mild valvular AS and PS in children using serial Doppler echocardiographic examinations. Materials and Methods: A total of 125 children, 50 with mild AS and 75 with mild PS, who underwent Doppler echocardiography were included in this study. The prognoses of mild AS and PS were compared according to age, gender, and valvular gradient at the time of initial diagnosis. Results: The mean age of patients was 26.1±37.6 months at diagnosis. The mean follow-up duration was 27.65±21.60 (1- 120) months. There was a significant decrease in the final gradient of the PS group compared to the baseline (23.58±6.97 vs. 19.88±11.21 mmHg, p=0.001). In the AS group, there was an increase in the final gradient, which was more pronounced in patients ≤1-year-old (22.42±6.12 vs. 27.74±14.12 mmHg, p=0.002). Four percent of patients in the PS group and 12% of patients in the AS group progressed to moderate to severe stenosis. All patients who progressed in the PS group were ≤1-year-old and male. Conclusion: The results showed that mild PS had a better prognosis than mild AS and that the risk of progression in AS was higher. Careful follow-up should be performed in mild PS cases ≤1-year-old, especially in boys, since progression may be detected, even if infrequently. Mild AS should also be followed closely, as the disease may show progressive characteristics in all age groups.

Supporting Institution

Scientific Research Projects Coordination Unit of Istanbul University.

Project Number

37697

References

  • 1. Rowland DG, Hammill WW, Allen HD, Gutgesell HP. Natural course of isolated pulmonary valve stenosis in infants and children utilizing Doppler echocardiography. Am J Cardiol 1997;79(3):344-9. [CrossRef]
  • 2. Hoffman JIE, Kaplan S. The incidence of congenital heart disease. J Am Cardiol 2002;39:1890-900. [CrossRef]
  • 3. Lakier JB, Lewis AB, Heymann MA, Stanger P, Hoffman JI, Rudolph AM. Isolated aortic stenosis in the neonate. Natural history and hemodynamic considerations. Circulation 1974;50(4):801-8. [CrossRef]
  • 4. Hossack KF, Neutze JM, Lowe JB, Barratt-Boyes BG. Congenital valvar aortic stenosis. Natural history and assessment for operation. Br Heart J 1980;43(5):561-73. [CrossRef]
  • 5. Skjaerpe T, Hegrenaes L, Hatle L. Non –invasive estimation of valve area in patients with aortic stenosis by Doppler ultrasound and two dimensional echocardiography. Circulation 1985;72(4):810-8. [CrossRef]
  • 6. Taylor R. Evolution of the continuity equation in the Doppler echocardiographic assessment of the severity of valvular aortic stenosis. J Am Soc Echocardiogr 1990;3(4):326-30. [CrossRef]
  • 7. Hatle L, Angelsen BA, Tromsdal A. Noninvasive assessment of aortic valve stenosis by Doppler ultrasound. Br. Heart J 1980;43(3):284-9. [CrossRef]
  • 8. Anand R, Mehta AV. Natural history of asymptomatic valvar pulmonary stenosis diagnosed in infancy. Clin Cardiol 1997;20(4):377-80. [CrossRef]
  • 9. Gielen H, Daniels O, van Lier H. Natural history of congenital pulmonary valvar stenosis: an echo and doppler cardiographic study. Cardiol Young 1999;9(2):129-35. [CrossRef]
  • 10. Horstkotte D, Loogen F. The natural history of aortic valve stenosis. Eur Heart J 1988;9(Suppl E):57-64. [CrossRef]
  • 11. Kitchiner D, Jackson M, Walsh K, Peart I, Arnold R. The progression of mild congenital aortic valve stenosis from childhood into adult life. Int J Cardiol 1993;42(3):217-23. [CrossRef]
  • 12. Weidman WH. Second natural history study of congenital heart defects. Circulation 1993;87(2 Suppl):I1-3.
  • 13. Hayes CJ, Gersony WM, Driscoll DJ, Keane JF, Kidd L, O’Fallon WM, et al. Second natural history study of congenital heart defects. Results of treatment of patients with pulmonary valvar stenosis. Circulation 1993;87(2 Suppl):128-37.
  • 14. Mody MR. The natural history of uncomplicated valvular pulmonic stenosis. Am Heart J 1975;90(3):317-21. [CrossRef]
  • 15. Lange PE, Onnasch DG, Heintzen PH. Valvular pulmonary stenosis. Natural history and right ventricular function in infants and children. Eur Heart J 1985;6(8):706-9. [CrossRef]

KONJENİTAL İZOLE HAFİF AORT KAPAK VE HAFİF PULMONER KAPAK DARLIĞININ DOĞAL SEYRİ: TEK MERKEZLİ BİR TAKİP ÇALIŞMASI

Year 2022, Volume: 85 Issue: 2, 242 - 248, 24.03.2022
https://doi.org/10.26650/IUITFD.1027281

Abstract

Amaç: Hafif aort darlığı (AD) ve hafif pulmoner darlığın (PD) doğal seyri hakkındaki bilgilerin birçoğu geçmiş 35-40 yıllık kardiak kateterizasyon kullanılarak yapılmış olan çalışmalara dayandırılmaktadır. Bu çalışmanın amacı, çocuk hastalarda izole hafif valvüler AD ve izole hafif valvüler PD’nin doğal seyrini, seri Doppler ekokardiyografik ölçümler ile ortaya koymaktı. Gereç ve Yöntem: Bu çalışmaya hafif AD tespit edilen 50 ve hafif PD tespit edilen 75, toplam 125 çocuk dahil edildi. Hafif AD ve PD’nin klinik seyirleri cinsiyet, ilk tanı anındaki yaş ve valvüler gradiyente göre karşılaştırıldı. Bulgular: Tanı yaşı ortalaması 26,1±37,6 ay (1 gün-13 yaş) idi. Çocukların ortalama izlem süresi 27,65±21,60 (1-120) aydı. PD grubunun final gradiyentlerinde başlangıca göre belirgin azalma saptandı (19,88±11,21’e karşı 23,58±6,97 mmHg, p=0,001). AD grubunda bir yaş altı hastalarda daha belirgin olmak üzere tüm hastaların final gradiyentlerinde artış saptandı (27,74±14,12’ye karşı 22,42±6,12 mmHg, p=0,002). AD grubunda final gradiyentin ortalaması, PD grubuna göre daha yüksekti (27,74±14,12’ye karşı 19,88±11,21 mmHg, p=0,001). PD grubunda toplamda hepsi erkek ve ≤1 yaş olan %4 hastada orta-ileri darlığa progresyon görüldü. AD grubunun %12’sinde orta-ileri darlığa progresyon görüldü. Hafif AD olanlardan iki hastaya, hafif PD olanlardan ise bir hastaya girişim yapıldı. Sonuç: Çalışmamızda hafif PD’nin hafif AD’ye göre seyrinin daha iyi olduğu ve AD’nin progresyon gösterme riskinin daha yüksek olduğu gösterildi. Bir yaş ve altındaki, özellikle erkek hafif PD olgularında sık olmasa da progresyon saptanabileceğinden dikkatli takip yapılmalıdır. Hafif AD ise, hastalık her yaş grubunda progresif özellik gösterebileceğinden yakın takip edilmelidir.

Project Number

37697

References

  • 1. Rowland DG, Hammill WW, Allen HD, Gutgesell HP. Natural course of isolated pulmonary valve stenosis in infants and children utilizing Doppler echocardiography. Am J Cardiol 1997;79(3):344-9. [CrossRef]
  • 2. Hoffman JIE, Kaplan S. The incidence of congenital heart disease. J Am Cardiol 2002;39:1890-900. [CrossRef]
  • 3. Lakier JB, Lewis AB, Heymann MA, Stanger P, Hoffman JI, Rudolph AM. Isolated aortic stenosis in the neonate. Natural history and hemodynamic considerations. Circulation 1974;50(4):801-8. [CrossRef]
  • 4. Hossack KF, Neutze JM, Lowe JB, Barratt-Boyes BG. Congenital valvar aortic stenosis. Natural history and assessment for operation. Br Heart J 1980;43(5):561-73. [CrossRef]
  • 5. Skjaerpe T, Hegrenaes L, Hatle L. Non –invasive estimation of valve area in patients with aortic stenosis by Doppler ultrasound and two dimensional echocardiography. Circulation 1985;72(4):810-8. [CrossRef]
  • 6. Taylor R. Evolution of the continuity equation in the Doppler echocardiographic assessment of the severity of valvular aortic stenosis. J Am Soc Echocardiogr 1990;3(4):326-30. [CrossRef]
  • 7. Hatle L, Angelsen BA, Tromsdal A. Noninvasive assessment of aortic valve stenosis by Doppler ultrasound. Br. Heart J 1980;43(3):284-9. [CrossRef]
  • 8. Anand R, Mehta AV. Natural history of asymptomatic valvar pulmonary stenosis diagnosed in infancy. Clin Cardiol 1997;20(4):377-80. [CrossRef]
  • 9. Gielen H, Daniels O, van Lier H. Natural history of congenital pulmonary valvar stenosis: an echo and doppler cardiographic study. Cardiol Young 1999;9(2):129-35. [CrossRef]
  • 10. Horstkotte D, Loogen F. The natural history of aortic valve stenosis. Eur Heart J 1988;9(Suppl E):57-64. [CrossRef]
  • 11. Kitchiner D, Jackson M, Walsh K, Peart I, Arnold R. The progression of mild congenital aortic valve stenosis from childhood into adult life. Int J Cardiol 1993;42(3):217-23. [CrossRef]
  • 12. Weidman WH. Second natural history study of congenital heart defects. Circulation 1993;87(2 Suppl):I1-3.
  • 13. Hayes CJ, Gersony WM, Driscoll DJ, Keane JF, Kidd L, O’Fallon WM, et al. Second natural history study of congenital heart defects. Results of treatment of patients with pulmonary valvar stenosis. Circulation 1993;87(2 Suppl):128-37.
  • 14. Mody MR. The natural history of uncomplicated valvular pulmonic stenosis. Am Heart J 1975;90(3):317-21. [CrossRef]
  • 15. Lange PE, Onnasch DG, Heintzen PH. Valvular pulmonary stenosis. Natural history and right ventricular function in infants and children. Eur Heart J 1985;6(8):706-9. [CrossRef]
There are 15 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section RESEARCH
Authors

Serra Başkan This is me 0000-0001-5421-0191

Pelin Karaca Özer 0000-0002-1085-5462

Kazım Öztarhan 0000-0001-9919-1414

Project Number 37697
Publication Date March 24, 2022
Submission Date November 24, 2021
Published in Issue Year 2022 Volume: 85 Issue: 2

Cite

APA Başkan, S., Karaca Özer, P., & Öztarhan, K. (2022). NATURAL HISTORY OF CONGENITAL ISOLATED MILD AORTIC VALVE AND MILD PULMONARY VALVE STENOSIS: A SINGLECENTER FOLLOW-UP STUDY. Journal of Istanbul Faculty of Medicine, 85(2), 242-248. https://doi.org/10.26650/IUITFD.1027281
AMA Başkan S, Karaca Özer P, Öztarhan K. NATURAL HISTORY OF CONGENITAL ISOLATED MILD AORTIC VALVE AND MILD PULMONARY VALVE STENOSIS: A SINGLECENTER FOLLOW-UP STUDY. İst Tıp Fak Derg. March 2022;85(2):242-248. doi:10.26650/IUITFD.1027281
Chicago Başkan, Serra, Pelin Karaca Özer, and Kazım Öztarhan. “NATURAL HISTORY OF CONGENITAL ISOLATED MILD AORTIC VALVE AND MILD PULMONARY VALVE STENOSIS: A SINGLECENTER FOLLOW-UP STUDY”. Journal of Istanbul Faculty of Medicine 85, no. 2 (March 2022): 242-48. https://doi.org/10.26650/IUITFD.1027281.
EndNote Başkan S, Karaca Özer P, Öztarhan K (March 1, 2022) NATURAL HISTORY OF CONGENITAL ISOLATED MILD AORTIC VALVE AND MILD PULMONARY VALVE STENOSIS: A SINGLECENTER FOLLOW-UP STUDY. Journal of Istanbul Faculty of Medicine 85 2 242–248.
IEEE S. Başkan, P. Karaca Özer, and K. Öztarhan, “NATURAL HISTORY OF CONGENITAL ISOLATED MILD AORTIC VALVE AND MILD PULMONARY VALVE STENOSIS: A SINGLECENTER FOLLOW-UP STUDY”, İst Tıp Fak Derg, vol. 85, no. 2, pp. 242–248, 2022, doi: 10.26650/IUITFD.1027281.
ISNAD Başkan, Serra et al. “NATURAL HISTORY OF CONGENITAL ISOLATED MILD AORTIC VALVE AND MILD PULMONARY VALVE STENOSIS: A SINGLECENTER FOLLOW-UP STUDY”. Journal of Istanbul Faculty of Medicine 85/2 (March 2022), 242-248. https://doi.org/10.26650/IUITFD.1027281.
JAMA Başkan S, Karaca Özer P, Öztarhan K. NATURAL HISTORY OF CONGENITAL ISOLATED MILD AORTIC VALVE AND MILD PULMONARY VALVE STENOSIS: A SINGLECENTER FOLLOW-UP STUDY. İst Tıp Fak Derg. 2022;85:242–248.
MLA Başkan, Serra et al. “NATURAL HISTORY OF CONGENITAL ISOLATED MILD AORTIC VALVE AND MILD PULMONARY VALVE STENOSIS: A SINGLECENTER FOLLOW-UP STUDY”. Journal of Istanbul Faculty of Medicine, vol. 85, no. 2, 2022, pp. 242-8, doi:10.26650/IUITFD.1027281.
Vancouver Başkan S, Karaca Özer P, Öztarhan K. NATURAL HISTORY OF CONGENITAL ISOLATED MILD AORTIC VALVE AND MILD PULMONARY VALVE STENOSIS: A SINGLECENTER FOLLOW-UP STUDY. İst Tıp Fak Derg. 2022;85(2):242-8.

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