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Surgical valvotomy versus balloon dilatation for children with severe aortic valve stenosis: a systematic review

Huzeifa Elhedai1, Salma Saeed S Mohamed2, Hamid Idriss3

  • 1Department of Cardiology, Birmingham Women's & Children's NHS Foundation Trust, Birmingham, UK.

Future Cardiology
|September 5, 2022
PubMed

Insights

Surgical aortic valvotomy (SAV) and balloon aortic dilatation (BAD) show similar survival rates for severe aortic stenosis. SAV offers better gradient reduction and lower aortic regurgitation post-procedure.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Severe aortic stenosis (AS) necessitates intervention to improve patient outcomes.
  • Surgical aortic valvotomy (SAV) and balloon aortic dilatation (BAD) are primary treatment options.
  • Comparative effectiveness of SAV versus BAD for severe AS requires detailed evaluation.

Approach:

  • A systematic review and meta-analysis was conducted.
  • Eleven studies comprising 1733 patients (743 SAV, 990 BAD) were analyzed.
  • Outcomes including mortality, need for aortic valve replacement, hemodynamic changes, and valve function were assessed.

Key Points:

  • No significant differences were observed in early, late, or total mortality between SAV and BAD.
  • Freedom from aortic valve replacement was comparable between the two intervention groups.
  • SAV demonstrated a significantly greater reduction in aortic systolic gradient and a lower rate of postprocedural aortic regurgitation compared to BAD.

Conclusions:

  • Both SAV and BAD are viable options for severe aortic stenosis regarding survival.
  • SAV provides superior hemodynamic improvement and better valve function post-intervention.
  • These findings suggest SAV may be preferred when significant gradient reduction and prevention of aortic regurgitation are key goals.

Keywords:
aortic regurgitationaortic stenosisballoon aortic dilatationmortalityreduction of aortic systolic gradientsurgical aortic valvotomy

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