Introduction. Balloon valvuloplasty (BVP) is one of the primary therapies for
congenital aortic stenosis in children and adolescents. The aim of this
interventional procedure is to gain time before possible surgical therapy
(aortic valve replacement) until adulthood. Objective. The aim of this study
was to evaluate the efficacy, safety and mid-term results of transcatheter
BVP in children and adolescent in our Center. Methods. From 2004 to 2011, 50
patients, aged 18 days to 18 years (mean 6.3 years) underwent BVP.
Retrospective analysis of the echocardiographic and hemodynamic parameters
were performed before and after procedure, especially peak pressure gradient
(PG) across the aortic valve, semiquantification of the aortic regurgitation
(AR) after the BVP as well as the left ventricle dimensions and functions.
Results. The mean peak PG in the whole group decreased from 74.80?27.72 mm Hg
to 27.86?13.04 mm Hg (p<0.001) after BVP. In 39 patients (78%), residual PG
was lower than 30 mm Hg just after dilation. At the end of follow-up period,
25 patients (50%) had PG above 50 mm Hg, measured by Doppler technique, and
four of them underwent re-dilation. Eight patients (16%) had severe AR.
During the follow-up period (12-80 months, mean 51 months), six patients
(12%) were referred to cardiac surgeons for aortic valve replacement or Ross
procedure. Conclusions. This retrospective study analyzes our first
experience of BVP as primary therapy of the congenital aortic stenosis. The
results confirmed that BVP effectively postponed the need for surgery in
children and adolescents toward the adulthood.
Follow-up Study of Aortic-Valve Replacement Surgery in Patients With Takayasu's Disease Complicated by Aortic Regurgitation
