Percutaneous transluminal balloon dilatation for discrete subaortic stenosis

Area of Science:

• Pediatric Cardiology
• Interventional Cardiology
• Congenital Heart Disease

Background:

• Discrete subaortic stenosis (DSS) is a significant cause of left ventricular outflow tract obstruction in children.
• Traditional surgical intervention for DSS carries risks; less invasive options are sought.
• Percutaneous transluminal balloon dilatation (PTBD) offers a potential alternative for managing DSS.

Purpose of the Study:

• To evaluate the safety and efficacy of PTBD for treating discrete subaortic stenosis in pediatric patients.
• To assess the immediate and mid-term hemodynamic and clinical outcomes following PTBD.

Main Methods:

• Seven pediatric patients with diagnosed DSS underwent PTBD during cardiac catheterization.
• Hemodynamic parameters (left ventricular pressure, gradient) and aortic regurgitation were measured before and after PTBD.
• Clinical findings and 2-dimensional echocardiography were used to assess the subvalvular membrane and treatment effectiveness.

Main Results:

• PTBD significantly reduced left ventricular systolic pressure (181 to 139 mm Hg) and peak gradient (65 to 12 mm Hg).
• Mild aortic regurgitation persisted in most patients, with one case resolving.
• No major complications were reported; clinical signs like precordial thrill resolved, and echocardiography confirmed membrane disruption.

Conclusions:

• PTBD is a safe and effective treatment for discrete subaortic stenosis in children.
• The procedure leads to significant hemodynamic improvement and symptom resolution.
• Mid-term follow-up confirms sustained hemodynamic benefits and stable aortic regurgitation.