Pediatric Heart Expert Forum
Stenotic murmur after aortic valve repair
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Stenotic murmur after aortic valve repair

Hello. I wanted to ask my son had an aortic valve repair using pericardial grafts in March this year. He is nearly 4 now and when I last took him to the doctor he said he could defiantly hear a stenotic murmur. As far as I was aware when he left hospital he had trivial regurgitation. His last echo summary states
Mild TR
Normal LV systolic function
Trileaflet aortic valve
Redundant NCC, trivial aortic regurgitation. Mild flow acceleration across aortic valve, V max 2.2m/s, mean gradient 10mmhg.
Normal coronary arteries. Flow seen in RCA and LMCA
No pericardial effusions.

Does any of this indicate stenosis as it is not actually stated? Or is the stenosis something that has been a more recent occurrence?
I would also add this is after his second admission for monitoring as he had a mild eschemic event in icu that resolved but proceeded to have another 8 days post op. He is currently on 15mg twice daily of atenolol and 100mg daily of aspirin.
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773637_tn?1327450515
Dear Tam,

Based on the echo report information that you have listed, it appears that he has mild residual stenosis of the aortic valve, which does not cause a problem.  That said, I tell all of my patients that aortic valve disease is something that you have for life in one way, shape, or form.  This valvuloplasty will not last him his whole life, as it will wear out and/or have an inflammatory response from the body that will make the valve leaky, more stenotic, or both.  It was done to get rid of the severe aortic valve regurgitation that can accompany a bicuspid aortic valve.  Although I cannot say for sure without evaluating him, it sounds like he had a reasonable repair with only limited obstruction and trivial residual leakage at the valve.  Please note that bicuspid aortic valves can become more stenotic and/or regurgitant over time, as well as having progressive aortic dilation.  Therefore, your son will need lifelong follow-up for his valve.
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The repair was to correct severe regurgitation due to a bicuspid valve. He had already had balloon procedure done at 8months for the moderate stenosis. He had pre surgery mild thickening of the ventricle wall and no other outward symptoms.
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