Skip to main content
SpringerLink
Log in

Serial Exercise Performance in Children with Surgically Corrected Congenital Aortic Stenosis

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

We examined serial exercise test performance in children with congenital aortic stenosis (AS) treated surgically compared to that of nonoperated children with mild to moderate AS. Maximal treadmill exercise data were assessed in 21 children 5.5 ± 3.8 years after aortic valve (AO) surgery. Patients had undergone the Ross procedure (n = 6) or previous aortic valvotomy, balloon valvuloplasty, or neonatal aortic valvotomy (n = 15). Follow-up treadmill tests were conducted 3.7 ± 2.8 years later. Data were compared to those of 19 nonoperated AS patients (mean gradient by echocardiogram <50 mmHg). These patients were exercised 3.6 ± 3.2 years apart. Endurance time, heart rate, systemic blood pressure, and electrocardiogram were compared as repeated measures between tests and to age- and sex-matched normative data. Postsurgical children with AS had normal endurance times despite low peak heart rates on the initial test, and they maintained endurance over time. Nonoperated children with mean AO gradients <50 mmHg also had normal endurance times on the initial test but increased endurance over 3.6 years. Children with operated and nonoperated AS were able to reach or exceed normal endurance times, which may make it difficult to achieve compliance to imposed activity restrictions in this population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. BS Alpert W Kartodihardjo R Harp T Izukawa WB Strong (1981) ArticleTitleExercise blood pressure response—a predictor of severity of aortic stenosis in children. J Pediatr 98 763–765 Occurrence Handle1:STN:280:Bi6C1MzptFI%3D Occurrence Handle7229755

    CAS  PubMed  Google Scholar 

  2. BS Alpert DM Moes RH Durant WB Strong NL Flood (1983) ArticleTitleHemodynamic responses to ergometer exercise in children and young adults with left ventricular pressure or volume overload. Am J Cardiol 52 563–567 Occurrence Handle1:STN:280:BiyA3crlsFE%3D Occurrence Handle6613878

    CAS  PubMed  Google Scholar 

  3. CW Barton B Katz MA Schork A Rosenthal (1983) ArticleTitleValue of treadmill exercise test in pre- and postoperative children with valvular aortic stenosis. Clin Cardiol 6 473–477 Occurrence Handle1:STN:280:BiuD38jivVw%3D Occurrence Handle6627767

    CAS  PubMed  Google Scholar 

  4. GS Bissett RA Meyer SS Hirschfeld et al. (1983) ArticleTitleAortic valve replacement in childhood: evaluation of left ventricular function by electrocardiography, echocardiography, and graded exercise testing. Am J Cardiol 52 568–572 Occurrence Handle6613879

    PubMed  Google Scholar 

  5. TJ Bricker (1993) Pediatric exercise electrocardiography. TW Rowland (Eds) Pediatric Laboratory Exercise Testing Human Kinetics Champaign IL 43–66

    Google Scholar 

  6. GR Cumming D Everatt L Hastman (1978) ArticleTitleBruce treadmill test in children: normal values in a clinic population. Am J Cardiol 41 69–75 Occurrence Handle1:STN:280:CSeC3c%2FjvVM%3D Occurrence Handle623008

    CAS  PubMed  Google Scholar 

  7. SE Cyran FW James S Daniels et al. (1988) ArticleTitleComparison of the cardiac output and stroke volume response to upright exercise in children with valvular and subvalvular aortic stenosis. J Am Coll Cardiol 11 651–658 Occurrence Handle1:STN:280:BieC2c%2Fht1w%3D Occurrence Handle3343467

    CAS  PubMed  Google Scholar 

  8. TP Graham JT Bricker FW James WB Strong (1994) ArticleTitle26th Bethesda Conference: recommendations for determining eligibility for competition in athletes with cardiovascular abnormalities: task force 1—congenital heart disease. J Am Coll Cardiol 24 867–873 Occurrence Handle7930218

    PubMed  Google Scholar 

  9. FW James DC Schwartz S Kaplan SP Spilkin (1982) ArticleTitleExercise electrocardiogram, blood pressure, and working capacity in young patients with valvular or discrete subvalvular aortic stenosis. Am J Cardiol 50 769–775 Occurrence Handle1:STN:280:BiyD3Mbls1Y%3D Occurrence Handle6214941

    CAS  PubMed  Google Scholar 

  10. PE Longmuir MS Tremblay RC Goode (1990) ArticleTitlePostoperative exercise training develops normal levels of physical activity in a group of children following cardiac surgery. Pediatr Cardiol 11 126–130 Occurrence Handle1:STN:280:By%2BA2s%2Fmt1Q%3D Occurrence Handle2395740

    CAS  PubMed  Google Scholar 

  11. GS Ormond FB Bessinger JH Moller (1980) ArticleTitleRest and exercise hemodynamics in children before and after aortic valvotomy. Am Heart J 99 76–86 Occurrence Handle7350754

    PubMed  Google Scholar 

  12. JH Oury DB Doty JD Oswalt et al. (1998) ArticleTitleCardiopulmonary response to maximal exercise in young athletes following the Ross procedure. Ann Thorac Surg 66 S153–S154 Occurrence Handle10.1016/S0003-4975(98)01029-7 Occurrence Handle1:STN:280:DyaK1M7islKhug%3D%3D Occurrence Handle9930438

    Article  CAS  PubMed  Google Scholar 

  13. DN Ross (1967) ArticleTitleReplacement of the aortic and pulmonary valves with the pulmonary autograft. Lancet 2 956–958 Occurrence Handle10.1016/S0140-6736(67)90794-5 Occurrence Handle1:STN:280:CCeD3cngs1Q%3D Occurrence Handle4167516

    Article  CAS  PubMed  Google Scholar 

  14. HD Ruttenberg TD Adama GS Orsmond RK Conlee AG Fisher (1983) ArticleTitleEffects of exercise training on aerobic fitness in children after open heart surgery. Pediatr Cardiol 4 19–24 Occurrence Handle1:STN:280:BiyC1MvlsFM%3D Occurrence Handle6844148

    CAS  PubMed  Google Scholar 

  15. AR Snider (1997) Methods for obtaining quantitative information from the echocardiographic examination. AR Snider GA Serwer SB Ritter (Eds) Echocardiography in Pediatric Heart Disease, 2nd edn. Mosby St. Louis 204–223

    Google Scholar 

  16. RL Washington JT Bricker BS Alpert et al. (1994) ArticleTitleGuidelines for exercise testing in the pediatric age group. Circulation 90 2166–2179 Occurrence Handle1:STN:280:ByqD3cfhsFU%3D Occurrence Handle7923708

    CAS  PubMed  Google Scholar 

  17. JT Whitmer FW James S Kaplan DC Schwartz MJ Sandker Knight (1981) ArticleTitleExercise testing in children before and after surgical treatment of aortic stenosis. Circulation 63 254–263 Occurrence Handle1:STN:280:Bi6D1cfmsV0%3D Occurrence Handle7449050

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Drs. Tom Weigel, Carl Backer, and Constantine Mavroudis for their assistance with the project and manuscript preparation. This work was supported in part by a grant from the Dr. Scholl Foundation.

Author information

Authors and Affiliations

  1. Dr. Scholl Cardiac Exercise Laboratory, Division of Cardiology, Children’s Memorial Hospital, Chicago, IL 60614, USA

    B. M. Mitchell, J. F. Strasburger, J. E. Hubbard & H. U. Wessel

Authors
  1. B. M. Mitchell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. F. Strasburger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. E. Hubbard
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. U. Wessel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B. M. Mitchell.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mitchell, B., Strasburger, J., Hubbard, J. et al. Serial Exercise Performance in Children with Surgically Corrected Congenital Aortic Stenosis . Pediatr Cardiol 24, 319–324 (2003). https://doi.org/10.1007/s00246-002-0281-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-002-0281-6

Keywords

Search

Navigation