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[Percutaneous transluminal valvuloplasty in aortic valve stenosis in children]
A M Worms1, F Marçon, J L Cloez
1Clinique des maladies cardio-vasculaires, CHU de Nancy-Brabois, Vandoeuvre-lès-Nancy.
Insights
Percutaneous transluminal balloon valvuloplasty is a treatment for tight aortic valve stenosis in children. This study evaluated its use in 12 pediatric patients, noting both successes and complications.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Context:
- Percutaneous transluminal balloon valvuloplasty (PTBV) has been utilized since 1983 for pediatric aortic valve stenosis.
- Indications for PTBV versus surgical valvulotomy remain incompletely defined.
- This study examines PTBV outcomes in a cohort of infants and children.
Purpose:
- To assess the efficacy and safety of percutaneous transluminal balloon valvuloplasty in treating pediatric patients with tight aortic valve stenosis.
- To analyze patient demographics, procedural details, and associated complications.
Summary:
- Twelve pediatric patients (3 infants, 9 children) with tight aortic valve stenosis underwent PTBV.
- Procedures involved single or multiple balloons, with diameters relative to aortic annulus size.
- Complications included one mortality from left ventricular perforation and one case of myocardial infarction.
Impact:
- Provides clinical insights into PTBV for pediatric aortic valve stenosis.
- Highlights the need for further definition of PTBV indications in comparison to surgical options.
- Contributes data on procedural risks and outcomes in a pediatric interventional cardiology setting.
Abstract:
Percutaneous transluminal balloon valvuloplasty has been used in children since 1983 to treat tight aortic valve stenosis. Although more than 100 cases have been published, its indications compared with those of surgical valvulotomy have not yet been clearly defined. Twelve patients with tight aortic valve stenosis underwent transluminal balloon valvuloplasty: 3 were infants whose ages ranged from 1 month and 24 days to 3 months and 23 days (mean 80 +/- 13.7 days), and 9 were children aged from 4 to 17 years (mean 10.44 +/- 4.61 years). Aortic regurgitation grade I (5) or grade III (1) was present in 6 cases. An 8-year old child had previously undergone surgical aortic valvulotomy simultaneously with repair of aortic coarctation. Other associated malformations were congenital grade III mitral regurgitation in 1 case and Turner's syndrome in 1 case. Dilatation was performed with one or two successive balloons in 11 patients and with two balloons concomitantly in 1 patient. The diameter of the balloon (or the sum of those of the two balloons) was 77 to 112 percent of the diameter of the aortic annulus, but in one case this figure rose to 119 percent after failure of dilatation with a smaller balloon. One infant died at the end of the dilatation, due to perforation of the left ventricle. Another infant developed inferior myocardial infarction which followed a favourable course and left minimal sequelae.(ABSTRACT TRUNCATED AT 250 WORDS)