Immediate And Midterm Results Of Balloon Aortic Valvuloplasty In Children With Aortic Valve Stenosis With Special Reference To Dysplastic Aortic Valve

J Ayub Med Coll Abbottabad. 2019 Oct-Dec;31(4):517-521.

Abstract

Background: This study was conducted to determine the immediate and midterm outcome of balloon aortic valvuloplasty in children from age 1 month to 16 years, with special reference to mean balloon to aortic valve ratio along with dooming versus dysplastic valve.

Methods: This was a retrospective cohort study. Patients who underwent balloon aortic valvuloplasty in a single tertiary care hospital were reviewed regarding immediate outcome, morphology of aortic valve, mean balloon to aortic valve ratio and complications during procedure from January 2006 till December 2016.

Results: Of 171 patients, 80.11% had fall to good results while 73.1% had adequate outcome. Mean gradient fall of more than 50% or Peak systolic gradient decreased significantly post ballooning, which indicates good results. The age ranges from 1-92 months, 89.4% patients from age group less than1 year had adequate outcome, (p=0.017). In terms of morphology, 55.6% cases had doming while 44.4% cases had dysplastic aortic valve. There was no significant difference between dysplastic and doming valves in terms of outcome (p=0.224). Only 6 patients (3.5%) developed significant aortic regurgitation. Regarding short-term and intermediate outcome 92% of the patients were free from a second intervention and there was no significant difference between complications regarding balloon to aortic valve ratio also.

Conclusions: Our 10-year experience showed that balloon aortic valvuloplasty is a safe and effective therapy, irrespective of age groups. The complications rate is low and good outcome is achieved by keeping balloon to aortic valve ratio of ±0.9 irrespective of morphology of valve..

Keywords: Balloon aortic valvuloplasty; Children; Congenital aortic valve stenosis.

MeSH terms

  • Adolescent
  • Aortic Valve / pathology
  • Aortic Valve Insufficiency / etiology
  • Aortic Valve Stenosis / congenital
  • Aortic Valve Stenosis / therapy*
  • Balloon Valvuloplasty* / adverse effects
  • Bicuspid Aortic Valve Disease
  • Child
  • Child, Preschool
  • Female
  • Heart Defects, Congenital / pathology
  • Heart Defects, Congenital / therapy*
  • Heart Valve Diseases / pathology
  • Heart Valve Diseases / therapy*
  • Humans
  • Infant
  • Male
  • Retrospective Studies
  • Systole
  • Time Factors
  • Treatment Outcome