Valvular aortal stenosis in children: anatomical variants, indications and time of intervention, repair techniques, outcomes, prospects

Congenital outflow tract obstruction in the left ventricle is determined by a considerable group of abnormalities and accounts for 5 to 10 % of all children with congenital heart disease (CHD) [1, 2, 5, 6]. It is characteristic that all groups of diseases have a similar clinical picture and pathological physiology of circulation. The main approach to repair is to adequately eliminate the outflow tract obstruction. Valvular stenosis occurs more frequently as compared to other obstructions (up to 60 - 70 %) and a range of treatment methods is diverse, from balloon dilatation of the aortal valve to complex reconstructive techniques (Koppo's modified procedure, Ross procedure) and univentricular correction [3, 7]. However, there are many open and controversial issues relating to its operative therapy, optimal time and methods of repair in order to obtain satisfactory short- and long-term results. Our review covers only biventricular correction, since it is reasonable to remove a left heart hypoplasia syndrome by using Norwood procedure.