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The Impact of Rapid Left Ventricular Pacing during Pediatric Aortic Valvuloplasty on Postprocedural Aortic

Ilker Ertugrul1, Tevfik Karagoz1, Alpay Celiker2

  • 1Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Congenital Heart Disease
|April 16, 2016
PubMed

Insights

Rapid left ventricular pacing (RLVP) effectively and safely reduces severe aortic insufficiency (AI) after balloon aortic valvuloplasty in children. This technique also lowers procedural failure rates and fluoroscopy time, easing the overall procedure.

Area of Science:

  • Pediatric Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Balloon aortic valvuloplasty (BAV) is a common procedure for treating aortic stenosis in children.
  • Aortic insufficiency (AI) is a potential complication of BAV.
  • Rapid left ventricular pacing (RLVP) has been proposed to improve BAV outcomes.

Purpose of the Study:

  • To evaluate the efficacy and safety of RLVP during BAV in pediatric patients.
  • To assess the impact of RLVP on the development of postprocedural AI.
  • To compare RLVP with the standard BAV technique.

Main Methods:

  • Retrospective comparison of 56 children undergoing BAV with RLVP versus 74 children undergoing BAV with the standard method.
  • Patient age ranged from 1 day to 18 years.
  • Outcomes assessed included procedural success, AI severity, and procedure duration.

Main Results:

  • RLVP significantly decreased the incidence of severe postprocedural AI (3.6% vs. 20.2%, P < .01).
  • Procedural failure rates were lower with RLVP (3.6% vs. 8.3%).
  • RLVP reduced fluoroscopy time but did not significantly affect gradient reduction or overall procedure duration.

Conclusions:

  • RLVP is an effective and safe pacing method during BAV in all pediatric age groups.
  • RLVP helps stabilize the balloon, preventing AI development.
  • The technique offers benefits including reduced procedural failure and fluoroscopy time.
Abstract

Keywords:
Balloon ValvuloplastyCongenital Aortic StenosisRapid Left Ventricular Pacing

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