# Outcomes of aortic valvuloplasty with pericardium patch for congenital aortic stenosis and regurgitation in pediatric patients

## TL;DR

Aortic valvuloplasty with a pericardium patch is a safe and effective treatment for congenital heart issues in children, including infants.

## Contribution

The study presents outcomes of AVP with pericardium patch in pediatric patients, including infants, over a four-year follow-up.

## Key findings

- Median peak aortic valve gradient decreased significantly postoperatively.
- No new moderate or severe aortic regurgitation was observed early after surgery.
- Four-year survival was 96% and freedom from reoperation was 75.4% in the overall cohort.

## Abstract

Surgical strategies for congenital aortic stenosis and regurgitation in children, particularly in infants (<1 year), remain controversial. Aortic valvuloplasty (AVP) with pericardial patch has gained increasing attention, but its durability and clinical benefits remain uncertain.

We retrospectively analyzed pediatric patients (≤12 years) undergoing AVP with pericardial patch in our center between July 2017 and July 2025. Infants (<1 year) were analyzed separately as subgroups. Primary outcome was the change in aortic valve hemodynamics, including median peak gradient, median peak velocity, and degree of aortic regurgitation. Secondary outcomes included major complications, overall survival, and freedom from reoperation.

A total of 35 patients were included, with a median age of 2 years. Among them, 17 were infants, with a median age of 2 months. The median peak aortic valve gradient decreased from 67.0 mmHg to 33.0 mmHg (p < 0.001), and the median peak velocity decreased from 4.1 m/s to 2.9 m/s (p < 0.001), postoperatively. No new moderate or severe aortic regurgitation was observed early postoperatively, and preexisting lesions of this severity were resolved. There were no in-hospital deaths or severe complications. At four years, survival was 96% and freedom from reoperation 75.4% in the overall cohort; in infants, survival was 100% with 66.7% freedom from reoperation.

AVP with pericardium patch is a safe and effective procedure for congenital aortic stenosis and regurgitation in pediatric patients. It represents a promising surgical option for pediatric patients, including infants.

Outcomes of aortic valvuloplasty with a pericardium patch are presented for pediatric patients. The methods section details 35 patients, including 17 infants, undergoing the procedure. Aortic hemodynamics shows changes in peak valve gradient and regurgitation levels pre- and post-operation. The four-year follow-up outcomes highlight freedom from reoperation. The procedure is described as a safe and effective surgical option for congenital aortic stenosis and regurgitation in children.