Related Experiment Videos
Comparison of single and double balloon valvuloplasty in children with aortic stenosis
R H Beekman1, A P Rocchini, D C Crowley
1Division of Pediatric Cardiology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor 48109-0204.
Insights
The double balloon technique for percutaneous balloon valvuloplasty in children with aortic stenosis offers superior gradient reduction compared to the single balloon method. Both techniques show similar complication rates, primarily mild aortic insufficiency.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Cardiovascular Surgery
Background:
- Valvular aortic stenosis is a significant congenital heart defect in children.
- Percutaneous balloon valvuloplasty is a common treatment for aortic stenosis.
- Comparing different balloon techniques is crucial for optimizing outcomes.
Purpose of the Study:
- To compare the effectiveness of single versus double balloon techniques for percutaneous balloon valvuloplasty in pediatric aortic stenosis.
- To assess short-term results and complications of both techniques.
Main Methods:
- A comparative study of two groups of children with valvular aortic stenosis.
- Group 1: Single balloon technique (n=16), balloon-to-annulus ratio 0.96.
- Group 2: Double balloon technique (n=11), balloon-to-annulus ratio sum 1.32.
Main Results:
- Overall valvuloplasty reduced peak systolic gradient by 53%.
- The double balloon technique resulted in a significantly lower post-valvuloplasty gradient (43% lower, p<0.01).
- Gradient reduction was 43% for single balloon vs. 67% for double balloon (p<0.001).
Conclusions:
- The double balloon technique is more effective in reducing the pressure gradient in pediatric aortic stenosis.
- Both techniques have similar short-term complication rates, including mild aortic insufficiency.
Abstract:
To compare the effectiveness of the single and double balloon techniques, the short-term results of percutaneous balloon valvuloplasty were assessed in two consecutive groups of children with valvular aortic stenosis. In 16 children (aged 3 months to 17 years) the single balloon technique was utilized; the ratio of balloon diameter to valve anulus diameter was 0.96 +/- 0.03 (mean +/- SEM). In 11 children (aged 3 months to 21 years) the double balloon technique was utilized in which two balloons are positioned across the valve and inflated simultaneously; the ratio of the balloon diameter sum to valve anulus diameter was 1.32 +/- 0.05. The groups were similar in age, weight, cardiac output, prevalvuloplasty gradient and valve anulus diameter. Overall, valvuloplasty reduced the peak systolic gradient by 53% from 80 +/- 4 to 38 +/- 3 mm Hg (p less than 0.0001). In the single balloon group the gradient decreased from 82 +/- 6 to 46 +/- 4 mm Hg (p less than 0.0001), whereas in the double balloon group the gradient decreased from 76 +/- 5 to 26 +/- 4 mm Hg (p less than 0.0001). The peak systolic gradient after valvuloplasty was 43% lower in the double balloon group (p less than 0.01). Furthermore, the single balloon technique reduced the gradient by an average of 43% compared with a 67% reduction with the double balloon technique (p less than 0.001). The short-term complications of valvuloplasty were similar, with an increase in aortic insufficiency occurring in three children in each group.(ABSTRACT TRUNCATED AT 250 WORDS)