Two decades of pediatric aortic stenosis: Balloon versus surgical interventions: A single center study

Area of Science:

• Cardiology
• Pediatric Cardiology
• Interventional Cardiology

Background:

• Congenital valvular aortic stenosis (AS) is a significant cause of congenital heart disease, affecting 3%-6% of affected children.
• Valvular AS necessitates timely intervention to prevent adverse cardiovascular events.

Purpose of the Study:

• To compare the clinical outcomes of balloon valvuloplasty (BV) versus surgical valvotomy (SV) in pediatric patients with congenital aortic stenosis.
• To evaluate the efficacy and safety of BV and SV in managing AS.

Main Methods:

• A retrospective analysis of 69 patients who underwent either BV or SV for AS between 2000 and 2023 at a tertiary heart center.
• Patient data included demographics, procedural details, and short-term and long-term follow-up outcomes.

Main Results:

• Both BV and SV effectively reduced pressure gradients across the aortic valve without significant differences (P > 0.05).
• Balloon valvuloplasty was associated with shorter hospitalization, fewer complications, and a lower rate of subsequent aortic valve replacement (4.1% vs. 20% for SV).
• Moderate-to-severe aortic insufficiency developed in 7% of BV patients and 19% of SV patients. Reintervention rates were comparable (4.2% for BV, 6.7% for SV).

Conclusions:

• Balloon valvuloplasty and surgical valvotomy offer comparable outcomes for congenital aortic stenosis.
• BV may be preferred due to shorter hospitalization, reduced complications, and lower rates of aortic valve replacement.
• Despite treatment, a significant proportion of patients may require reintervention over time.