[Balloon valvuloplasty in congenital aortic stenosis]

The authors discuss their experience with balloon valvuloplasty (BVP) in aortic valvular stenosis (AVS) in 3 patients aged 10 months, 15 and 16 years. BVP was carried out in all of them with exposure of the right subscapular artery. Left ventricular (LV) systolic pressure before BVP was 198 +/- 45 mm Hg on the average, systolic pressure gradient between the LV and the aorta was 102-32 mm Hg. After BVP systolic pressure in the LV reduced by 26.5% and was 146 +/- 27.8 mm Hg, the systolic pressure gradient between the LV and the aorta reduced by 64.8% and was 36.0 +/- 7.5 mm Hg. No increased regurgitation of contrasted blood through the valve into the LV was demonstrated by repeated aortography. Complications connected with BVP were not encountered. Thus, BVP may be an alternative to surgery in congenital AVS. This method is evidently indicated for patients of early age with AVS, which allows operations with extracorporeal circulation to be avoided. According to the authors, BVP is expedient in congenital AVS in older patients when the diameter of the aortic valvular ring is less than 20 mm.