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[Percutaneous balloon aortic valvuloplasty for congenital valvular aortic stenosis in children]
Wei Wang1, Chun-hong Xie, Cheng-sen Xia
1Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Insights
Percutaneous balloon aortic valvuloplasty (PBAV) effectively reduced gradients in pediatric congenital aortic stenosis (AS). This safe procedure offers a valuable alternative to surgery for children with AS.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Context:
- Congenital valvular aortic stenosis (AS) is a significant cause of heart disease in children.
- Surgical aortic valvulotomy carries risks, necessitating alternative treatment options.
Purpose:
- To evaluate the efficacy and safety of percutaneous balloon aortic valvuloplasty (PBAV) for treating congenital AS in pediatric patients.
Summary:
- PBAV was performed in 16 children with congenital AS, achieving successful gradient reduction in most cases.
- Significant hemodynamic improvement was observed, with no instances of moderate to severe aortic insufficiency.
- Repeat procedures or surgery were required in 3 cases due to gradient recurrence, but overall outcomes were favorable.
Impact:
- PBAV demonstrates significant hemodynamic improvement and relative safety in pediatric patients with AS.
- This interventional technique provides a viable alternative to surgical intervention for congenital aortic stenosis.
- The findings support PBAV as an important treatment option in the management of pediatric AS.
Objective:
To assess the effect of the balloon valvuloplasty for congenital valvular aortic stenosis (AS) in children.
Methods:
A total of twenty one children with AS accepted the treatment of percutaneous balloon aortic valvuloplasty (PBAV). One of them complicated with PDA underwent PDA closure by using Amplatzer occluder in the mean time. PBAV could not be accomplished in 3 cases because the catheter could not be advanced into left ventricle and PBAV was not performed in 2 cases due to the gradient pressures across aortic valves less than 50 mm Hg (1 mm Hg = 0.133 kPa). The procedure was completed in 16 cases. The ratios of balloon/valve were 0.98 +/- 0.04 (0.92 - 1.10).
Results:
13 cases had more than 50% gradient reduction (81.25%), 2 had 40% - 50% gradient reduction. The follow up period ranged from 3 months to 5 years. The gradient pressures rose to more than 50 mm Hg after follow up in 3 cases and they underwent repeat balloon valvuloplasty procedure or were operated successfully. There was no moderate to severe aortic insufficiency (AI).
Conclusion:
The result of balloon aortic valvuloplasty showed the significant hemodynamic improvement with relative safety in pediatric patients. PBAV provides another choice in comparison with surgery.
