Estenose aórtica valvar crítica no recém-nascido. Avaliaçäo clínica e resultados cirúrgicos em 18 pacientes / Critical aortic stenosis in the neonate. Clinical assessment and surgical outcome in 18 patients

RESUMO

OBJECTIVE - To assess neonates with aortic stenosis with early decompensation operated upon. (LCO) (CHF). METHODS - A and retrospective study analyzing 6 neonates with LCO, group I (GI), and 12 neonates with CHF, group II (GII). Clinical radiographic, electrocardiographic and echocardiographic findings also provided comparative bases for the study, as did surgical and evolutional findings. RESULTS - The mean ages at hospitalization and surgery (p = 0.0031) were 14.3 and 14.8 days in GI and 35.4 and 42.8 days in GII, respectively. Cardiac murmurs were more intense in GII (p = 0.0220). The aortic ring was smaller in GI (8.0 2.5mm) as compared to GII (11.4_1.4mm) (p = 0.2882). Vntricular function was reduced to 18_5.5 percent and 3.3_7.6 percent in GI and GII, respectively (p = 0.0162). Artic atresia, however, was present only in 2 neonates in GI. Five of 6 patients in GI died but all patients in GII survived (p=0.0007). In the latter group, 84.6 percent of the patients were infunctional class I (FC-I) in the long-term follow-up, with moderate residual lesions in 6 neonates, discrete residual lesions in 4, and reoperation in 2. CONCLUSION - Aortic stenosis is a severe anomaly of the neonate, whose immediate evolution depends on the pre-operative anatomic and functional findings, and the late evolution essentially depends on the anatomic features of thevalve