Combined Aortic and Pulmonic Valvular Stenosis: Report of 2 Cases
Thanarat Layangool MD*, Worakan Promphan MD*, Tawatchai Kirawittaya MD*, Chaisit Sangtawesin MD*, Perapat Makarapong MD**
Affiliation : * Cardiology Unit, Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University, Bangkok, Thailand ** Cardiovascular Surgery Unit, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
Objective : To report 2 cases of severe combined aortic and pulmonic valvular stenosis.
Material and Method: To find patients with a diagnosis of severe combined aortic and pulmonic valvular stenosis, the
authors searched in the patient profile at the cardiology unit, Queen Sirikit National Institute of Child Health (QSNICH) from
1995 to 2010.
Results : There are 2 cases of severe combined aortic and pulmonic valvular stenosis from 19,416 case records of pediatric
cardiac patients. The first one is a 9-year-old girl and the other is a male neonate. The interval between the presentations of
these two cases was 10 years. The older patient, who had associated moderate aortic regurgitation, underwent aortic root
replacement and pulmonic valvulotomy in the year 2000. The neonate, who presented in 2010 had undergone bilateral
percutaneous balloon aortic and pulmonic valvuloplasty and required repeated balloon aortic valvuloplasty at the age of two
months. Both patients responded well to treatment and were asymptomatic at the last follow-up of 10 years and 6 months
respectively after treatment.
Conclusion : Combined aortic and pulmonic valvular stenosis is a very rare congenital heart disease. The prevalence is
0.01% of congenital heart disease at QSNICH. Bilateral balloon valvuloplasty of aortic and pulmonic valve is effectively
performed in this rare congenital heart disease and can be done safely in a sick neonate.
Keywords : Aortic valve stenosis (AVS), Pulmonic valve stenosis (PVS), Congenital heart disease (CHD), Aortic valvulo- plasty, Pulmonic valvuloplasty
