Aortic stenosis occurs when
the aortic valve didn't form properly. A normal valve
has three parts (leaflets or cusps), but a stenotic
valve may have only one cusp (unicuspid) or two cusps
(bicuspid), which are thick and
stiff.
Sometimes
stenosis is severe and symptoms occur in infancy.
Otherwise, most children with aortic stenosis have no
symptoms. In some children, chest pain, unusual tiring,
dizziness or fainting may occur. The need for surgery
depends on how severe the stenosis is. In children, the
surgeon may be able to enlarge the valve opening.
Although surgery may improve the stenosis, the valve
remains deformed. Eventually, replacing the valve with
an artificial one may be
needed.
A procedure
called balloon valvuloplasty has been used in some
children who have aortic stenosis. During cardiac
catheterization, a special catheter containing a balloon
is placed across the constricted or narrowed valve. Then
the balloon is inflated, and the valve is stretched
open. The long-term results of this procedure are still
being studied.
Children with aortic
stenosis need lifelong medical follow-up. Even mild
stenosis may worsen over time. Also, surgical relief of
a blockage is sometimes incomplete. After surgery the
valve keeps working in a mildly abnormal way. Some
patients may have to limit how much they can do of some
kinds of exercise. Check with your pediatric
cardiologist about these exercise limits. Children
with aortic stenosis risk an infection of the valve
(endocarditis) before and after treatment. It
needs to be determined whether your child will need to
take antibiotics before certain dental procedures to
help prevent endocarditis.