oa Cardiovascular Journal of Africa - Critical aortic stenosis in infancy: when is a hypoplastic left ventricle too small?



Severe aortic stenosis in infants has a high early mortality after aortic valvotomy, whether done by surgery or balloon. Part of this mortallity might be that some left ventricles in these infants are too small to support an adequate circulation post-valvotomy. Both empirical studies of valvotomy results and a physiological model suggest that even in the absence of associated lesions, survival is unlikely for infants with left ventricular volumes much below 20 ml/m1. These infants shouJd he prepared for a univentricular repair by some operation like the Norwood procedure, followed later by a Footan-type procedure.


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