Aortic Valve Surgery in Congenital Heart Disease: A Single-Center Experience *Kasim Oguz Coskun, *Aron Frederik Popov, *Theodor Tirilomis, *Jan Dieter Schmitto, †Sinan Tolga Coskun, ‡Jose Hinz, *Friedrich Albert Schoendube, and *Wolfgang Ruschewski Departments of *Thoracic Cardiovascular Surgery and ‡Anaesthesiology, Emergency and Intensive Care Medicine, University of Göttingen; and †Department of Cardiovascular Surgery, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany Abstract: The optimal treatment of congenital aortic valve lesions is a controversial issue. This study was performed to evaluate the outcome after surgical treatment of aortic valve lesions in congenital aortic valve disease. Between the years of 2000 and 2008, 61 patients (mean age: 12.6  9.6 years, range: 1 day to 40 years) underwent aortic valve surgery for congenital aortic valve disease. Twenty- four patients had undergone previous cardiovascular operations. Indications for surgery were aortic regurgita- tion in 14.7% (n = 9), aortic stenoses in 26.2% (n = 16), and mixed disease in 59.1% (n = 36). The Ross procedure was performed in 37.7% (n = 23), aortic valve replacement with biological or mechanical prostheses in 29.5% (n = 18). Con- comitant procedures were performed in 91.8% (n = 56) due to associated congenital cardiac defects. The overall mortality rate was 5%. Six patients needed reoperation. Implantation of permanent pacemakers occurred in six patients for permanent atrioventricular block. At the latest clinical evaluation, all survivors are in New York Heart Association class I–II and are living normal lives. Aortic valve surgeries in patients with congenital heart disease have had low mortality and morbidity rates in our series. Surgical technique as well as timing should be tailored for each patient. Aortic valve replacement should be delayed until the implantation of an adult-sized prosthesis is possible. Key Words: Aortic valve—Congenital heart disease—Lesion—Repair—Replacement—Surgery. Despite the improvement of diagnostic and surgi- cal techniques, management of congenital aortic valve disease is a controversial issue. Hemodynamic instability and the presence of associated additional cardiac defects make it a high-risk proposition, par- ticularly in neonates. Congenital aortic valve lesions account for 2–6% of congenital heart diseases, and aortic stenoses occur in 5–6% of infants and children (1–4). Bicuspid aortic valves are the most common con- genital cardiac anomaly that occur in 1–2% of the general population (5–7). Because management of aortic valve lesions is challenging, there are several treatment options available for consideration: balloon valvuloplasty (BVP), commissurotomy, sub- aortic stenosis (SAS) resection, Ross procedure, aortic valve repair (AVR), and aortic valve replacement. This retrospective study was performed to evaluate early and midterm outcome after surgical treatment of aortic valve lesions in congenital aortic valve disease in our center. MATERIALS AND METHODS Study group Between the years of 2000 and 2008, 61 patients underwent aortic valve surgery due to congenital heart disease and were analyzed in this nonrandom- ized retrospective study after the Ethics Committee at the University of Goettingen waived the need of consent of Institutional Review Board approval. doi:10.1111/j.1525-1594.2009.00958.x Received May 2009; revised August 2009. Address correspondence and reprint requests to Dr. Kasim Oguz Coskun, Department of Thoracic and Cardiovascular Surgery, University of Göttingen, Robert-Koch-Straße 40, 37099 Göttingen, Germany. E-mail: dr_coskunok@yahoo.de Presented at the 5th International Conference on Pediatric Mechanical Circulatory Support Systems & Pediatric Cardiopul- monary Perfusion held May 28–30, 2009 in Dallas, TX, USA. Artificial Organs 34(3):E85–E90, Wiley Periodicals, Inc. © 2010, Copyright the Authors Journal compilation © 2010, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc. E85