Turk Kardiyol Dern Ars. 1997; 25(2): 108-113
Balloon Valvuloplasty in Congenital Aortic Stenosis in Children: Early and Intermediate-term Results
, Enver EKİCİ1
, Ali KUTSAL1
, Coşkun İKİZLER1
Percutaneous balloon valvuloplasty (BAV) has proven to be acutely effective in the treatment of congenital valvar aortic stenosis. Thirty-seven BAV procedure was performed in 35 patients aged 4 days to 20 years old (median 5.7 years). Balloon dilatation was performed retrogradly though the femoral artery in 34 patients and antegradly through the femoral vein in one patient. Maximum inflated balloon size was selected as equal to or slightly less than the diameter of the aortic annulus measured angiographically. Average balloon/annulus ratio was 0.96±0.06 Balloon dilatation of coexistent aortic coarctation and pulmonary valvar stenosis was performed at the same procedure in 2 patients. Transamtic gradient decreased from 93.2±33.3 mmHg to 33.0±19.6 mmHg after BAV (p<.OOI). and left ventricular peak systolic pressure decreased from 174.4±41.2 to 126.5±24.6 mmHg (p<.001). Patients had no aortic regurgitation (AR) in 19 procedure and mild aortic regurgitation in 18 procedure before BAV. There were increased in degree of AR in 11 procedure (29.7%). Four of these 11 patients ( 1 1. 1%) had 3+ regurgitation. Despite technically adequate valvuloplasty procedure, two patients had inadequate relief of obstruction and one required aortic valve replacement. Residual peak systolic aortic gradient was 3 1.5± 16.8 (12-90) mmHg at mean 22±16.3 (median 16) months followup in 22 patients. Aortic insufficiency was 3+ in 7,2 + in 8,1+ in 8 patients. Increasement of aortic regurtation during follow-up one degree in 10 patients, two degree in 1 patients, and did not change in 15 patients. Femoral artery complication occured in 3 patients in whom two were under 12 months of age. In conclusion; our results in aortic valvuloplasty provides safe and effective acute and intermediate-term results in infants, children and adolescent with congenital aortic stenosis comparing surgical valvotomy, and this effectiviness continues early and intermediate-term follow-up.
How to cite this article
N.Kürşad TOKEL, Enver EKİCİ, Ali KUTSAL, Coşkun İKİZLER. Balloon Valvuloplasty in Congenital Aortic Stenosis in Children: Early and Intermediate-term Results. Turk Kardiyol Dern Ars. 1997; 25(2): 108-113