Does mild valvular aortic stenosis progress during childhood?
GROUND AND AIM OF THE STUDY: An increased gradient in congenital valvular aortic stenosis (AS) during follow up remains the subject of controversy, and may determine a need for treatment in pediatric patients. It is hypothesized that a valvular gradient < 40 mmHg indicates a stable tendency at follow up for congenital valvular AS. METHODS: Twenty-five cases with valvular AS, isolated but not treated, were followed for eight years (range: 0.14-18.8 years). Clinical and complementary tests (electrocardiography, X-radiography) were undertaken. The gradient anatomy and function were measured using M-mode, two-dimensional, and Doppler echocardiography. RESULTS: No significant changes were noted in symptoms or at physical examination. Signs of cardiac enlargement were decreased (p < 0.001), and the functional status and gradient remained stable during the follow up period (mean difference 2.38 mmHg; p = 0.74). The relationship between gradient and age showed a slowly increasing trend (r = 0.