There is a big vessel in heart that is known as AORTA that supplies pure blood to whole body. Whenever there is narrowing in the proximal part of this vessel, it is known as aortic stenosis.
Narrowing can happen either at the level of valve, or below or above the valve.
Most commonly seen narrowing in children is at the level of aortic valve commonly known as valvular aortic stenosis (due to bicuspid aortic valve). Rest are known as subvalvular or supravalvular aortic stenosis.
When there is severe narrowing especially at the level of aortic valve, it is known as critical aortic stenosis. Generally seen in newborns and babies may be in shock like state.
Presentation depends on severity of stenosis or narrowing.
In mild aortic stenosis: children do not show any symptoms and got noticed by a pediatrician on hearing an abnormal sound on examination.
In severe aortic stenosis: children show signs of early tiredness, chest pain, loss of consciousness (syncope) and in later stages with shortness of breath (dyspnea due to heart failure).
Best modality for detection of aortic stenosis is by doing PEDIATRIC ECHOCARDIOGRAPHY.
Treatment of choice in aortic stenosis depends on type and severity of aortic stenosis.
- Valvular aortic stenosis like bicuspid aortic valve stenosis:
In mild to moderate valvular obstruction: child needs to be on regular follow-up.
In severe valvular obstruction:child needs to undergo early ballooning of aortic valve for relieving the narrowing at the valve known as “Balloon Aortic Valvuloplasty”.
- In sub-valvular and supra-valvular aortic stenosis: treatment of choice is by doing open heart surgery as ballooning in these situations is not helpful.
No medicine can cure the aortic stenosis.
After ballooning: one month then 3, 6, 12 months after the procedure.
After surgery: after 3 days for wound dressing, then 1, 3, 6, 12 months after surgery.
By cardiac angiography from blood vessels of thigh that are connected with the heart. Ballooning is done in a beating heart. This procedure is generally done under conscious sedation