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Published on: February 8, 2022
Balloon dilatation for discrete subaortic stenosis: immediate and intermediate-term results
P S Rao1, A D Wilson, P S Chopra
1Departments of Pediatrics and Surgery, University of Wisconsin Medical School, Madison.
The Journal of Invasive Cardiology
|February 8, 1990
Summary
Percutaneous balloon angioplasty effectively reduced left ventricular outflow tract gradients in children with subvalvar aortic stenosis. This minimally invasive procedure showed encouraging intermediate-term results for discrete subaortic membranous stenosis.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Subvalvar aortic stenosis (SAS) is a significant congenital heart defect.
- Discrete subaortic membranous stenosis is a common form of SAS.
- Effective treatment options for pediatric SAS are crucial.
Purpose of the Study:
- To evaluate the efficacy and safety of percutaneous balloon angioplasty for subvalvar aortic stenosis in children.
- To assess immediate and intermediate-term outcomes, including pressure gradients and aortic insufficiency.
Main Methods:
- Retrospective review of six pediatric patients with subvalvar aortic stenosis.
- Percutaneous balloon angioplasty performed over a 15-month period.
- Assessment of systolic pressure gradients and aortic insufficiency via Doppler echocardiography pre- and post-procedure, and at follow-up.
Main Results:
- Significant reduction in mean systolic pressure gradient from 56 +/- 19 mmHg to 12 +/- 7 mmHg immediately post-angioplasty (p < 0.001).
- No significant increase in aortic insufficiency observed.
- Follow-up (mean 11 months) showed a residual gradient of 21 +/- 5 mmHg, significantly lower than baseline (p < 0.001).
- Patients with discrete membranous obstruction showed sustained gradient reduction, while one infant with tunnel-type obstruction had increased gradient.
Conclusions:
- Balloon angioplasty is an effective and safe treatment option for discrete subaortic membranous stenosis in children.
- The procedure leads to significant and sustained reduction in pressure gradients with minimal risk of increased aortic insufficiency.
- Percutaneous balloon angioplasty should be considered in the initial management of pediatric subvalvar aortic stenosis.
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