Percutaneous aortic balloon valvuloplasty under echocardiographic guidance solely

Percutaneous balloon aortic valvuloplasty (PBAV) is an alternative to surgical valvulotomy for the treatment of congenital aortic stenosis (AS). This article aims to summarize our preliminary experience on feasibility and safety of PBAV under only echocardiographic guidance in patients with congenital AS.

Clinical data from 20 consecutive patients with aortic valve stenosis who underwent PBAV under only echocardiographic guidance at Fuwai Hospital from January 2016 to January 2019 were analyzed retrospectively. Median age of patients was 18.38±15.88 years and 65% of the patients were male. Aortic annulus diameter was 18.40±3.25 mm and balloon diameter was 17.38±3.89 mm, with B/A ratio of 0.93±0.06.

All the patients successfully underwent PBAV. The peak transaortic gradient (TG) significantly decreased from 81.59±24.91 (range, 58-112) mmHg preoperatively to 36.32±12.83 (range, 16-51) mmHg (P=0.000) immediately post operation, without significant difference in aortic regurgitation (AR). At mean 24.31±17.35 months follow-up, peak TG was 37.06±13.52 (range, 21-58) mmHg which was not significantly different from the immediate postoperative value (P=0.65).

In this retrospective, single center study, systematic use of Doppler echocardiography as only guidance modality for PBAV was feasible and associated with a high success rate and a very low complication rate.