Long-term survival following intervention for severe congenital aortic valve stenosis is excellent and comparable between balloon aortic valvuloplasty and surgical aortic valvotomy, though reintervention is common, particularly in neonates.
Overall survival after primary intervention for severe congenital aortic valve stenosis was excellent at both 10 and 25 years.
There was no statistically significant difference in overall survival between balloon aortic valvuloplasty and surgical aortic valvotomy, though a trend may exist.
Reintervention occurred in approximately half of all patients and at similar rates between the two primary intervention strategies.
Neonatal intervention was associated with significantly lower freedom from reintervention.
Freedom from mechanical or autograft aortic valve replacement remained high and was not significantly different between BAV and SAV.
Patients undergoing surgical aortic valvotomy were significantly younger at the time of primary intervention compared to those undergoing balloon aortic valvuloplasty.
The authors recommend development of a national aortic valve stenosis registry based on the study findings.
This research examined 30 years of outcomes for children under 18 who received treatment for severe congenital aortic valve stenosis — a condition where the heart's aortic valve is too narrow from birth — at a single UK centre. The study compared two main treatment approaches: balloon aortic valvuloplasty (BAV), where a balloon is inflated to widen the valve through a catheter, and surgical aortic valvotomy (SAV), where surgeons directly repair the valve. A total of 231 patients were included, treated between 1995 and 2024. The study found that long-term survival was excellent overall: approximately 99% of patients were alive at 10 years, and about 92% at 25 years. Importantly, survival rates were not significantly different between the two treatment approaches. However, nearly half of all patients required an additional procedure (reintervention) at some point, with newborns (neonates) being far more likely to need further treatment than older children. Despite common reintervention, most patients did not progress to needing a full valve replacement — about 67–75% remained free from valve replacement at 10 to 25 years. This research suggests that both BAV and SAV are effective long-term options for children with severe congenital aortic valve stenosis, and that decisions between them should be guided by each patient's specific anatomy and clinical circumstances rather than a one-size-fits-all approach. The high rate of reintervention, especially in newborns, underscores the importance of lifelong follow-up and care planning for these patients. The authors also highlight that a national registry tracking all patients with this condition would help better understand outcomes across different centres and improve future treatment decisions.
Tarmahomed A, Binnersley T, Davidson C, Crucean A, Poole E, Twabi H, et al.. (2026). Long-term outcomes after primary intervention for congenital aortic valve stenosis: a 30-year single-centre experience.. Open heart. https://doi.org/10.1136/openhrt-2026-004332